Attitudes toward breastfeeding among college-educated African-American women

Background: Although breastfeeding is a key public health objective, data have repeatedly shown racial/ethnic disparities in breastfeeding initiation rates, with African-American women at lower rates than other groups. Studies examining factors for this disparity have almost exclusively focused on African-American women who are low-income. Purpose: To examine attitudes toward breastfeeding among a college-educated African-American population and compare these attitudes for women with children and those at pre-conception. Methods: 149 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 breastfeeding attitudes. Results: Respondents were subdivided into 2 groups: those who did not have a child (N=70) and those who had at least one child (N=79). They were asked to respond to 15 attitudinal statements (“True”, “False”, “Unsure”) grouped into 4 categories: infant feeding convenience, modesty concerns, health knowledge/concerns, and other. Those with children were more likely to endorse convenience of infant feeding but less likely to have health (milk insufficiency, breastfeeding difficulty, breastfeeding pain) or modesty concerns (breastfeeding in public). Those without children were 5 times more likely to be unsure of their responses overall (14.8% vs. 2.7%) and were more likely to report being unsure in 14/15 attitude statements. Conclusion: This study provides some support for the notion of health care providers having early discussions during preconception with women regarding some of the practical health concerns and attitudes that African-American women may have regarding breastfeeding.