Reflections of black women who choose to breastfeed: Influences, challenges and supports

Many black women initiate breastfeeding, but then cease nursing often within a few days.  We aimed to identify factors that influence and challenge black women who choose to breastfeed, and supportive strategies that impact their breastfeeding continuity in the early postpartum period. 

Four focus groups were conducted (N=16). Eligible women self-identified as black, were > 18 years, read and spoke English, were pregnant or had delivered an infant within the prior 5 years, and were willing to discuss breastfeeding in a group.  A standard set of questions guided discussions. Data saturation occurred after three groups. Two independent reviewers reviewed transcripts for recurrent words and themes with categories emerging. Text units were coded into relevant categories. Reviewers met periodically to resolve ambiguities and coding discrepancies until analysis was completed.

Mean age was 31.35 years with a mean of 14.94 years of education. The number of pregnancies ranged between first pregnancy to seven pregnancies (M=2.44). Four major categories emerged with additional subthemes:  Balancing the influences: People, myths, and technology; Being in the know; Critical periods; and, Supportive Transitions. Little influence of health providers/systems was noted by most participants. More influential to breastfeeding duration was the interplay of family members, myths and the internet “as my friend” (well-informed or not).

Women such as our participants are critical partners as we develop future systems of care to improve breastfeeding success. Findings underscore the importance of multiple user-friendly options readily available for a personalized plan that can be accessed by women who choose to breastfeed.