Increasing Breastfeeding Initiation, Duration and Exclusivity among African-American Women Enrolled in Women, Infants and Children Using The Social Cognitive Theory

Background:  Breastfeeding initiation, duration and exclusivity rates are historically lower among participants in The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).  Nationally, 19.3% of WIC participants are black or African-American, a group whose breastfeeding rates are traditionally lower than other racial/ethnic groups.

Objective:  To review the literature on breastfeeding initiation, duration and exclusivity rates of women enrolled in WIC, mainly the African-American participants, and formulate evidence-based research and program planning strategies for WIC and health educators within the framework of the Social Cognitive Theory (SCT).

Method:  Articles, consistent with the objective, from peer-reviewed literature published from 1976 to 2014 were reviewed.  Article selection preference was given to studies conducted in the United States that focused on one or more constructs of the SCT.

Conclusions:  The amount of perceived control a woman has over her environments and events in her life may have an effect on how the constructs of SCT apply to her breastfeeding journey.  The professional support provided through WIC may offer a mother the necessary tools problem solving skills to overcome defeating infant feeding moments, either from her own experience or expressed through those in her environments, to maintain a high level of breastfeeding self-efficacy.  Advanced research studies and WIC program components, with the intention of increasing breastfeeding initiation, duration and exclusivity, may be developed based on the constructs of SCT with particular attention paid to the initial evaluation of the various environments the women will be exposed to that may affect her breastfeeding outcomes.