Early Infant Feeding Decisions in Low-Income Latinas

Abstract

Breastfeeding rates remain low, especially among low-income minority women. The objective of this qualitative study was to assess barriers to breastfeeding and reasons for combination feeding among low-income Latina women and their families. Meetings were held with key informants to inform the sampling plan and develop questions for focus groups. Data were collected from eight qualitative focus groups with primiparous mothers postpartum, mothers breastfeeding at 4 to 6 months, mothers formula feeding at 4 to 6 months, grandmothers and fathers, and 29 individual interviews with formula- and combination-feeding mothers. Transcripts of focus groups and interviews were content coded and analyzed for thematic domains and then compared for concurrence and differences. Four main domains with 15 categories were identified: (a) Best of both: Mothers desire to ensure their babies get both the healthy aspects of breast milk and "vitamins" in formula. (b) Breastfeeding can be a struggle: Breastfeeding is natural but can be painful, embarrassing, and associated with breast changes and diet restrictions. (c) Not in Mother's Control: Mothers want to breastfeed, but things happen that cause them to discontinue breastfeeding. (d) Family and cultural beliefs: Relatives give messages about supplementation for babies who are crying or not chubby. Negative emotions are to be avoided so as to not affect mother's milk. Those counseling Latina mothers about infant feeding should discourage and/or limit early supplementation with formula, discuss the myth of "best of both," understand the fatalism involved in problem-solving breastfeeding issues, and enlist the altruism embedded in the family unit for support of the mother-infant pair.

Differences in modifiable feeding factors by overweight status in Latino infants

“…These findings are consistent with evidence from several studies documenting Latinas preference nonexclusive breastfeeding or formula feeding. [8][9][10][11][12][13][32][33][34][35] However, our rates of exclusive breastfeeding were lower than those reported in the literature, [36] as nearly none of breastfeeding infants were receiving breast milk exclusively. The one exclusive breastfed infant belonged in the overweight group and further analysis of this infant"s dietary intake revealed the mother reported frequently breastfeeding as often as 20 times during a 24-hour period.…”

“…[7,8] Favorable beliefs about combining breast milk and formula feeding may contribute to very low rates of exclusive breastfeeding. [9][10][11] Many Latina mothers recognize the importance and benefits of breastfeeding, but often provide complimentary formula feeding for fear of their ability to keep their infants sated and well-nourished. [12,13] A C C E P T E D M A N U S C R I P T…”

Are 2 Weeks of Daily Breastfeeding Support Insufficient to Overcome the Influences of Formula?

“…Nurses followed scripted protocols developed with the input of national breastfeeding authorities and local WIC and public health officials. Cultural issues previously found to influence breastfeeding initiation or continuation 16 were incorporated into the protocols. Script topics included: 1) advantages of colostrum and importance of a good latch; 2) engorgement; 3) concerns about unnecessary formula supplementation, supply and demand, assessing milk supply via infant stooling patterns; 4) sore nipples and thrush; 5) breastfeeding duration and benefits; 6) causes of infant crying; 7) modesty, family support, violation of la cuarentena (ie, 40 days postpartum); 8) support groups and WIC; 9) mother's illness; 10) baby blues versus postpartum depression; 11) medications and diet; 12) pumping and milk storage; 13) return to work or school or time away from baby; and 14) growth spurts and cluster feeding.…”

Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth

“…Some Latino parents consider that providing food for their children is an important aspect of good parenting (58)(59)(60), but this value can promote childhood obesity. A study among Latino women at risk for diabetes reported that improved economic conditions since immigration facilitated access to "high status foods" but, unfortunately, a less healthy diet as well (61).…”