Social norms and infant feeding myths: Implications for clinical and community interventions

Breastfeeding rates among low-income US women remain low despite numerous initiatives. Understanding the role of myths about infant feeding in perpetuating community norms may provide further insight into how to influence community attitudes about healthy infant feeding practices. We surveyed a Community Council (low-income, minority, urban residents), a partner in a community based participatory research study, about whether they heard and believed myths regarding infant feeding. Following each of two surveys (2010 n=14; 2011 n=19), the Council participated in a qualitative process evaluation. Heavily debated topics included if: adding cereal to a bottle helps a baby sleep through the night (yes=73.7%); breastfeeding is painful (yes=66.7%); smoking mothers may breastfeed (yes=54.5%). Discussions of results provided opportunities for Council members to reexamine their views and highlighted how myths influence infant feeding decision making. Some members' beliefs shifted over time, while others remained unaffected. Members unable to identify why they supported a belief tended to alter their view to be in accordance with accurate or more up-to-date information. However this factual information, even when presented by a professional, rarely convinced a member to change their inaccurate view when an identified trusted family “expert” endorsed a belief. Overall, members would not speculate about how others make decisions, reinforcing the principle that the target population must be directly represented in community based participatory research teams. Relevant public health and clinical implications regarding breastfeeding include how to: identify what people actually believe; effectively address erroneous information; counter the influence of powerful advisors.