Maternal and Child Health Journal

, Volume 8, Issue 2, pp 65–70 | Cite as

Predictors of Breastfeeding Intention Among Low-Income Women

  • Amal K. Mitra
  • Amal J. Khoury
  • Agnes W. Hinton
  • Cathy Carothers


Objective: Breastfeeding rates are below the Healthy People 2010 goals despite recognized benefits of breastfeeding. This study determined factors that predict breastfeeding initiation among low-income pregnant women. Methods: A self-administered closed-ended questionnaire was introduced to 694 pregnant women who were certified for WIC in Mississippi. The questionnaire collected data about demographics, breastfeeding intention, breastfeeding knowledge, self-efficacy, and three recognized barriers to breastfeeding: embarrassment, time and social constraints, and lack of social support. Results: In bivariate analysis, women who intended to breastfeed were more often white and had at least some college education, higher income, a smaller family size, fewer children, and previous breastfeeding experience than women who did not intend to breastfeed. Intenders had higher levels of breastfeeding knowledge and self-efficacy and reported fewer barriers to breastfeeding than nonintenders. In multivariate logistic regression, fewer children, past breastfeeding experience, breastfeeding knowledge, self-efficacy, and perceived social support were independent predictors of breastfeeding intention. Conclusions: Women at high risk for not wanting to breastfeed can be identified for additional support. Interventions should focus on improving breastfeeding knowledge, enhancing confidence in one's ability to breastfeed, and overcoming barriers to breastfeeding, especially lack of social support, among low-income women.

breastfeeding intention knowledge self-efficacy barriers 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    American Academy of Pediatrics. Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997;100:1035–9.Google Scholar
  2. 2.
    Mitra AK, Rabbani F. The importance of breastfeeding in minimizing mortality and morbidity from diarrhoeal diseases: The Bangladesh perspective. J Diarrhoeal Dis Res 1995;13:1–7.Google Scholar
  3. 3.
    Wong SC. Physicians should be educated on the benefits of breastfeeding. Am Fam Physician 2002;66:209–10.Google Scholar
  4. 4.
    Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 2002;360:187–95.Google Scholar
  5. 5.
    Labbok MH. Effects of breastfeeding on the mother. Pediatr Clin North Am 2001;48:143–58.Google Scholar
  6. 6.
    US Department of Health & Human Services. Healthy People 2010. Increase the proportion of mothers who breastfeed their babies. Retrieved December 19, 2003, from Scholar
  7. 7.
    Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: The importance of personal and familial experiences in making infant-feeding choices. J Hum Lact 2002;18:38–45.Google Scholar
  8. 8.
    Humphreys AS, Thompson NJ, Miner KR. Intention to breastfeed in low-income pregnant women: The role of social support and previous experience. Birth 1998;25:169–74.Google Scholar
  9. 9.
    Khoury AJ, Mitra AK, Hinton A, Carothers C, Sheil H. An innovative video succeeds in addressing barriers to breastfeeding among low-income women. J Hum Lact 2002;18:125–31.Google Scholar
  10. 10.
    Janke JR. Development of the breast-feeding attrition prediction tool. Nurs Res 1994;48:100–4.Google Scholar
  11. 11.
    Alikasifoglu M, Erginoz E, Gur ET, Baltas Z, Beker B, Arvas A. Factors influencing the duration of exclusive breastfeeding in a group of Turkish women. J Hum Lact 2001;17:220–6.Google Scholar
  12. 12.
    Forste R, Weiss J, Lippincott E. The decision to breastfeed in the United States: Does race matter? Pediatrics 2001;108:291–6.Google Scholar
  13. 13.
    Mahoney MC, James DM. Predictors of anticipated breastfeeding in an urban, low-income setting. J Fam Pract 2000;49:529–33.Google Scholar
  14. 14.
    Barton SJ. Infant feeding practices of low-income rural mothers. MCN Am J Matern Child Nurs 2001;26:93–7.Google Scholar
  15. 15.
    Arlotti JP, Cottrell BH, Lee SH, Curtin JJ. Breastfeeding among low-income women with and without peer support. J Commun Health Nurs 1998;15:163–78.Google Scholar
  16. 16.
    Matich JR, Sims LS. A comparison of social support variables between women who intend to breast or bottle feed. Soc Sci Med 1992;34:919–27.Google Scholar
  17. 17.
    Bulk-Bunschoten AM, van Bodegom S, Reerink JD, Pasker-de Jong PC, de Groot CJ. Reluctance to continue breastfeeding in the Netherlands. Acta Paediatr 2001;90:1047–53.Google Scholar
  18. 18.
    Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M. Factors associated with initiation and duration of breastfeeding in Italy. Acta Paediatr 1999;88:411–5.Google Scholar
  19. 19.
    Wambach KA. Breastfeeding intention and outcome: A test of the theory of planned behavior. Res Nurs Health 1997;20:51–9.Google Scholar
  20. 20.
    Balcazar H, Trier CM, Cobas JA. What predicts breastfeeding intention in Mexican-American and non-Hispanic white women? Evidence from a national survey. Birth 1995;22:74–80.Google Scholar
  21. 21.
    Buxton KE, Gielen AC, Faden RR, Brown CH, Paige DM, Chwalow AJ. Women intending to breastfeed: Predictors of early infant feeding experiences. Am J Prev Med 1991;7:101–6.Google Scholar
  22. 22.
    Dennis CL, Faux S. Development and psychometric testing of the Breastfeeding Self-Efficacy Scale. Res Nurs Health 1999;22:399–409.Google Scholar
  23. 23.
    Papinczak TA, Turner CT. An analysis of personal and social factors influencing initiation and duration of breastfeeding in a large Queensland maternity hospital. Breastfeed Rev 2000;8:25–33.Google Scholar
  24. 24.
    Scott JA, Binns CW. Factors associated with the initiation and duration of breastfeeding: A review of the literature. Breastfeed Rev 1999;7:5–16.Google Scholar
  25. 25.
    Bar-Yam NB, Darby L. Fathers and breastfeeding: A review of the literature. J Hum Lact 1997;13:45–50.Google Scholar
  26. 26.
    Isabella PH, Isabella RA. Correlates of successful breastfeeding: A study of social and personal factors. J Hum Lact 1994;10:257–64.Google Scholar
  27. 27.
    Littman H, Medendorp SV, Goldfarb J. The decision to breastfeed. The importance of father's approval. Clin Pediatr (Phila) 1994;33:214–9.Google Scholar
  28. 28.
    Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, Hutchins SS, Johnson LK. Predicting early breastfeeding attrition. J Hum Lact 2002;18:21–8.Google Scholar

Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  • Amal K. Mitra
    • 1
  • Amal J. Khoury
    • 1
  • Agnes W. Hinton
    • 1
  • Cathy Carothers
    • 2
  1. 1.Center for Community HealthThe University of Southern MississippiHattiesburg
  2. 2.Best Start Social MarketingTampa

Personalised recommendations