Deciding on infant-feeding method early: Does it increase a woman's commitment to breastfeed?

Background: Successful breastfeeding has been identified by a recent qualitative study as characterized by “confident commitment”. This includes: confidence in the process of breastfeeding and in the woman's ability to breastfeed and a commitment to make breastfeeding work despite obstacles. Purpose: To examine the importance of early decision-making regarding infant-feeding method (IFM) in contributing to the development of confident commitment regarding breastfeeding initiation/duration among college-educated African-American women, a subgroup frequently not studied in terms of infant-feeding choices. Methods: 85 African-American women were recruited through the alumni association of Spelman College and through local chapters of Delta Sigma Theta sorority. They were asked to complete a survey questionnaire through Survey Monkey regarding their infant-feeding choices. Results: Respondents were subdivided into 2 groups: those who had decided on their IFM either prior to or at the time of pregnancy (N=59) and those who decided later (N=26). The timing of their decision was considered a measure of their commitment to their IFM. The early deciders were more likely to: have breastfed their baby, have continued breastfeeding until at least 6 months, introduced solid food after 4 months, and to have rated the selection of an IFM as “very important”. They were also more likely to continue breastfeeding despite obstacles such as complications, lack of support, and returning to work full-time. Conclusion: This study provides some early support for the notion of confident commitment as an important characteristic of increased breastfeeding initiation and duration.