African American mothers breastfeeding 6 months and beyond: A Positive Deviance Inquiry of WIC participants in Georgia

According to recent CDC reports, about 30% of African-American (AA) women  and 34% of WIC participants breastfed at 6 months. However, research has seldom highlighted longer-term breastfeeding in women who are both AA and WIC participants. This presentation describes dissertation research using Positive Deviance to explore AA WIC participants breastfeeding experiences and factors influencing their longer durations of breastfeeding. Theory of Planned Behavior (TPB) guided the interview protocol and data analysis.  One-hour semi-structured interviews were conducted with 11 AA mothers participating in Georgia WIC program. Women had to identify as African-American, currently participate in WIC, have history breastfeeding ≥ 6 months, and recently breastfed a child age ≤ 2 years. Interviews were audio-recorded, professionally transcribed and analyzed using thematic analysis. Participants ages ranged from 23 to 35 years, had on average 3 children, with 55% married and 36% holding college degrees. Patterns include breastfeeding decision often occurring after birth (not during pregnancy), breastfeeding experience differs with each child, and reliance on pumping to continue breastfeeding. Of those reporting working or attending school, about half described sufficient breastfeeding accommodations. Public breastfeeding was described as challenging and uncomfortable. WIC peer counselors were reliable sources of support. Only 1 participant mentioned attending a support group. Determination and sacrifice were commonly cited as maternal characteristics needed to breastfeed long-term.  Future breastfeeding promotion efforts for AA women should include increasing media exposure of AA women breastfeeding, encouraging healthcare providers to discuss breastfeeding during pregnancy, and improving breastfeeing accommodations at workplace, school childcare and public settings.