Infant Feeding Decision-Making and the Influences of Social Support Persons Among First-Time African American Mothers
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Background While breast milk is considered the gold standard of infant feeding, a majority of African American mothers are not exclusively breastfeeding their newborn infants. Objective The overall goal of this critical ethnographic research study was to describe infant feeding perceptions and experiences of African American mothers and their support persons. Methods Twenty-two participants (14 pregnant women and eight support persons) were recruited from public health programs and community based organizations in northern California. Data were collected through field observations, demographic questionnaires, and multiple in-person interviews. Thematic analysis was used to identify key themes. Results Half of the mothers noted an intention to exclusively breastfeed during the antepartum period. However, few mothers exclusively breastfed during the postpartum period. Many participants expressed guilt and shame for not being able to accomplish their antepartum goals. Life experiences and stressors, lack of breastfeeding role models, limited experiences with breastfeeding and lactation, and changes to the family dynamic played a major role in the infant feeding decision making process and breastfeeding duration. Conclusions for Practice Our observations suggest that while exclusivity goals were not being met, a considerable proportion of African American women were breastfeeding. Future interventions geared towards this population should include social media interventions, messaging around combination feeding, and increased education for identified social support persons. Public health measures aimed at reducing the current infant feeding inequities would benefit by also incorporating more culturally inclusive messaging around breastfeeding and lactation.
KeywordsAfrican American mothers Social support Breastfeeding Combination feeding Ethnography Infant feeding Messaging Qualitative research
The authors want to acknowledge and thank all of the study participants and recruitment sites. We also want to thank Kathryn Lee for her critical critique of the manuscript.
This study was supported by the National Institutes of Health (NIH), National Institute of Nursing Research (NINR) (Grant 5F31NR013120), UCSF Graduate Student Research Award and Sigma Theta Tau International, Alpha Eta Research Award and also supported in part by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number KL2TR000143. The contents are solely the responsibility of the authors and do not represent the views of NIH, NINR, UCSF or Sigma Theta Tau International.
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Conflict of interest
The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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