WIC Peer Counselors’ Perceptions of Breastfeeding in African American Women with Lower Incomes

Abstract

Background African-American women have the lowest breastfeeding rates among all racial/ethnic groups in the United States. Peer counseling is an effective intervention in improving breastfeeding in this population. However, little is known on peer counselors’ perceptions of breastfeeding in African-American women. Objectives As part of a larger qualitative study, the goal of this study was to understand the contextual factors influencing breastfeeding decisions of low-income African-American women from the perspective of breastfeeding peer counselors (PCs). Methods Three focus groups were conducted with 23 PCs from the WIC program in a Southeastern state. All focus group discussions were audio-recorded, professionally transcribed, and analyzed using thematic analysis. Bronfenbrenner’s socio-ecological model was used to group categories into themes. Results Of the sample, 48% were African-American, 78.2% were married, 56.5% had some college education. Five main themes emerged to describe factors at multiple-levels influencing breastfeeding in PCs’ low-income African-American clients: Individual, Microsystem, Exosystem, Macrosystem, and Chronosystem. Novel findings included 1) having breast-pumps may give African-American women a “sense of security”, 2) cultural pressures to be a “strong black woman” can impede breastfeeding support, and 3) breastfeeding “generational gaps” have resulted from American “slavery” and when formula was “a sign of wealth”. Conclusions As PCs described, low-income African-American women breastfeeding decisions are impacted by numerous contextual factors. Findings from this study suggest a need to broaden public health approach to breastfeeding promotion in this population by moving beyond individual characteristics to examining historical and socio-cultural factors underlying breastfeeding practices in African-American women.

Barriers to Human Milk Feeding at Discharge of Very-Low-Birth-Weight Infants: Maternal Goal Setting as a Key Social Factor

“…In addition, black mothers and/or maternal grandmothers may still positively associate formula with a sign of wealth and status. 35,36 Interventions that seek to support young mothers may wish to focus on this complex relationship, with its benefits and challenges, between the infant's mother and maternal grandmother, 27,37 especially when breastfeeding is not an experience that has been shared by the grandmother in her own parenting history.…”

Does breast-feeding reduce offspring junk food consumption during childhood? Examinations by socio-economic status and race/ethnicity

“…Recent research has revealed that Breastfeeding Peer Counseling Programs have had positive effects on increasing breast-feeding initiation and continuation for black mothers enrolled in WIC (68,69) . Breastfeeding Peer Counseling Programs have discovered that black women tend to place high value on breast pumps as a matter of convenience and a way to exert control over breast-feeding (67) . Moreover, the educational component of the Breastfeeding Peer Counseling Program regarding the benefits of breast milk for infants has resulted in increasing breast-feeding rates among black WIC participants (59,64) .…”

“…Not only has research revealed breast-feeding to be less common among WIC participants (58)(59)(60)(61)(62)(63)(64) , it has also revealed that black WIC participants have the lowest breast-feeding rates (59,63) and are significantly less likely to receive breast-feeding advice from their health-care providers and/or WIC counsellors than white participants (59,64,65) . In an effort to improve breast-feeding rates among WIC participants, especially black participants, the WIC programme expanded its breast-feeding education to include the Breastfeeding Peer Counseling Program (66,67) . The WIC peer counsellor must have breast-fed at least one child for 6 months or longer and be a current or previous WIC participant.…”

Dukungan Informasi bagi Ibu-ibu Menyusui dalam Memberikan ASI Eksklusif di Kecamatan Gondokusuman Kota Yogyakarta

“…Kim (2001), menyebutkan bahwa seorang perempuan bisa mendapatkan informasi mengenai ASI eksklusif dari berbagai sumber, keluarga, teman, media cetak, classes prenatal, dan tenaga kesehatan. Keputusan ibu menyusui (Gross, 2015) untuk memberikan ASI kepada anak mereka dipengaruhi oleh banyak faktor, diantaranya kondisi kontekstual dari ibu tersebut. Diperlukan sebuah pendekatan kesehatan masyarakat untuk promosi ASI yang lebih luas diluar karakterstik individu dari ibu menyusui, seperti riwayat dan sosial budaya yang mendasari pemberian ASI.…”