Increasing Breastfeeding Initiation, Duration and Exclusivity Among Low-Income, African-American Women Using the Health Belief Model

Background:  Current rates of breastfeeding initiation, duration and exclusivity among low-income and African-American women in the United States are substantially lower than other racial and ethnic groups.  

Objective:  To review the literature on breastfeeding initiation, duration and exclusivity rates among low income, African-America females and formulate evidence-based research and program planning strategies for health educators within the framework of the Health Belief Model.

Method: Articles, consistent with the objective, from peer-reviewed literature published after 2000 were reviewed.  Article selection preference was given to studies conducted in the United States that focused on one or more constructs of the Health Belief Model.

Conclusions: The decision to breastfeed is largely based on elements that directly relate to the constructs of the Health Belief Model.  Breastfeeding intention of African-American women was associated with increased knowledge about breastfeeding, previous experience and positive beliefs about breastfeeding.  Breastfeeding in public, ensuring proper infant nourishment, time consumption, perceived lessened paternal bonding, possible pain and accident embarrassment were among common barriers revealed.  Expanding on and pooling current research is key to identifying the main elements of each Health Belief Model construct that need to be focused on in low-income, African-American females.  Results from new research initiatives and strategies formulated may be used to create new breastfeeding education programs that contain elements from each Health Belief Model construct with the end goals of increasing breastfeeding initiation, duration and exclusivity rates among African-American women in the United States.