202508 Early breastfeeding termination in a WIC population: A mixed methods approach

Monday, November 9, 2009

Marycatherine Augustyn, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Caitlin Cross-Barnet, MA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Baltimore, MD
Susan M. Gross, PhD, MPH, RD , Food Supplement Nutrition Education, University of Maryland Cooperative Extension, Columbia, MD
David M. Paige, MD MPH , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Introduction Many WIC clients prematurely discontinue breastfeeding despite program efforts to increase initiation, duration and exclusivity. We report factors associated with early breastfeeding termination for African American (AA) women enrolled in 3 geographically representative Maryland WIC sites. Mixed method analysis of quantitative and qualitative data furthers our understanding of early breastfeeding termination in these mothers. Design Quantitative data from the WIC administrative base revealed that 338 AA women at these sites terminated breastfeeding by 1 month. A convenience sample of participants with infants at these sites was interviewed. Of 55 interviewed, 17 AA mothers breastfed ≤ 1 month. Results Quantitative analysis revealed the most likely termination reasons: "mother chose to wean"; mothers' dislike; latch problems; milk inadequacy; and nipple pain. Qualitative analysis expands these findings, revealing the most likely termination reasons: pain; milk inadequacy; pumping issues; and latch problems. Termination reasons revealed through qualitative methods further elucidating the quantitative response "mother chose to wean" were: pump issues, allowing infant feeding by others; and infant health issues. Discussion In this population, qualitative results reinforce quantitative results. Pain, milk inadequacy, and latch problems lead to early breastfeeding termination. Qualitative analysis clarified the close ended response "mother chose to wean." Breastfeeding termination reasons revealed by this mixed methods approach include those resolvable through education and support. Peer counseling is proving successful in increasing breastfeeding initiation, duration, and exclusivity for Maryland WIC participants. Our results highlight specific barriers to breastfeeding continuation that should be addressed in breastfeeding education and support, including breastfeeding peer counseling.

Learning Objectives:
1.Identify reasons associated with early breastfeeding termination in a WIC population; 2. Compare quantitative and qualitative methodology results of early breastfeeding termination reasons in a WIC population; 3. Discuss programmatic implications for WIC breastfeeding education and support

Keywords: Breast Feeding, WIC

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: PhD in Behavioral Science and Health Education; Developed qualitative analysis protocol for evaluation of the Maryland WIC Peer Counselor Program; analyzed qualitative data for study; participated in quantitative methodology and analysis of evaluation of Maryland Breastfeeding peer counseling program
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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