What Does Infant Feeding Mean to African American Women and Their Support Persons

Background: While overall breastfeeding initiation and continuation rates in the US have increased, disparities in breastfeeding rates between African American women and White women remain.  African American infants have the highest rates of infant mortality, premature birth, low birth weight and very low birth weight and can benefit greatly from an increase in breastfeeding.  The purpose of this study was to understand and describe infant feeding practices of African American mothers as well as the infant feeding perceptions and experiences of their support persons. 

Methods: Twenty-two participants (14 pregnant women and 8 support persons) were interviewed about and observed for infant feeding decisions during the antepartum and postpartum periods using a critical ethnographic approach. Through thematic analysis, key themes were identified. 

Results: Most participants intended to breastfeed exclusively before birth, noting the importance of breastfeeding and its benefits for mothers and infants.  Yet combination feeding (the use of both breast milk and formula feeding) was a common occurrence after birth, and participants felt guilty for not being able to breastfeed exclusively.  Life experiences (e.g., lack of breastfeeding role models, education, and/or employment) also played a role in intentions and perceptions about breastfeeding. 

Conclusion: These data suggest African American women want to breastfeed and that future interventions geared towards this population should include messaging around combination feeding and increased support for all mothers regardless of their infant feeding method.  Public health measures aimed at reducing the current infant feeding disparities would benefit by incorporating a more culturally inclusive message around breastfeeding.