Relationship characteristics associated with breastfeeding encouragement within support networks of low-income new mothers

Background: Breastfeeding provides substantial health benefits for infants and their mothers. Previous studies suggest that peer and professional support are important to the success of breastfeeding, but little is known about the types of social relationships associated with support provision to guide interventions.  This study evaluated the characteristics of low-income mothers and the social relationships they have with support network members that are associated with encouragement to exclusively breastfeed and encouragement to breastfeed in combination with formula feeding.

Methods: Social relationships between 287 support network members and 80 mothers with infants between the ages of 0-12 months in Memphis, TN were analyzed using two-level logistic regression models accounting for relationships nested within participant networks.

Results:  Exclusive breastfeeding encouragement was more likely to come from healthcare professionals (OR=6.177, 95%CI: 2.013, 18.956), those participating in making feeding decisions (OR=2.136, 95%CI: 1.198, 3.807), and those whose own children were exclusively breastfed (OR=5.981, 95%CI: 2.654, 13.480).  Encouragement to breastfeed in combination with formula was more likely to come from those who provide emotional support (OR=3.541, 95%CI: 1.805, 6.944), whose opinion was important to the participant (OR=2.557, 95%CI: 1.033, 6.329), and whose own children were fed using a combination feeding method (OR=7.369, 95%CI: 2.844, 19.092). 

Conclusions: Interventions to facilitate breastfeeding encouragement within mothers’ social networks should consider social norms related to infant feeding within the network and incorporating members who are likely to provide effective encouragement (e.g., those who are emotionally close and important to new mothers) in discussion about the benefits of breastfeeding.