Infant Feeding Decision-Making and the Influences of Social Support Persons Among First-Time African American Mothers

Abstract

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. Purpose 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. Conclusion 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.

Racial and Ethnic Differences in Reasons for Breastfeeding Cessation Among Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children

“…Maternal perception that the infant is not satisfied by breastmilk is a common concern, and this study suggests that counseling should consider women's nativity. Hence, nonnative populations may benefit from health care professionals who are trained to respond to concerns regarding infant satisfaction with breast milk . Marital status and education also predicted reasons for breastfeeding cessation, which has previously been recognized among this WIC population .…”

Toward Understanding How Social Factors Shaped a Behavioral Intervention on Healthier Infant Formula-Feeding

“…Research in this area is still scarce, and longer term research designs with time to develop rapport and trust could provide more in-depth insights into feeding practices. More sophisticated qualitative research designs that go beyond, for example, small interview or focus groups studies could greatly enhance the understanding of participants’ experiences ( Asiodu, Waters, Dailey, & Lyndon, 2017 ), and inform interventions both in their planning and evaluation phase. In particular, such sophisticated qualitative research designs could better contribute to accounting for complexity in complex interventions, exploring in-depth the target behavior(s) (here: infant feeding, mothering, and so forth) and target population (here: women of varied backgrounds, social support, experiences with health professionals, and stigma).…”

“…Yet, in other public health fields such as the prevention of sexually transmitted diseases and teenage pregnancy, the public health stance favors harm reduction, the provision of advice and condoms, without fearing to discourage abstinence ( Underhill, Montgomery, & Operario, 2007 ). A solution could be to provide support and information material more generally for “combination feeding” that would avoid singling out and therefore stigmatizing particular feeding practices ( Asiodu et al, 2017 ). How to challenge societal norms that promote excess weight gain in infants seems an equally challenging task; that the Baby-Milk Trial managed to achieve changed feeding practices at least indicates an opportunity to do so.…”

Experiences of online breastfeeding support: Support and reassurance versus judgement and misinformation

“…Social support from friends and family is also a key influence upon breastfeeding success. Mothers who feel encouraged to breastfeed by others are more likely to start and continue breastfeeding (Asiodu, Waters, Dailey, & Lyndon, ; Brown, Raynor, & Lee, ; Meedya, Fahy, & Kable, ). Yet due to geographical mobility, many mothers are isolated from family (Arendell, ).…”