Perceptions and Practices of Infant Feeding among African American Women

ABSTRACT

A large urban hospital in Florida implemented changes to achieve the Baby-Friendly Hospital Initiative (BFHI) designation in 2015 resulting in an increase of exclusive breastfeeding rates at hospital discharge; however, African American women continue to have the lowest rates overall. Qualitative interviews were conducted with 20 African American women who received prenatal care at a low-income women’s clinic and gave birth at an affiliated BFHI hospital. Using a medical anthropology analytical framework to examine predisposing, enabling, and service-related factors that affect breastfeeding, this study investigated interpersonal, sociocultural, and institutional barriers to breastfeeding. Common challenges experienced by participants included lack of maternity leave from work, lack of access to electric pumps, social pressures to initiate formula supplementation, fears that breastfeeding renders infants overly dependent on their mother’s care, and a lack of breastfeeding role models and/or support networks to normalize longer-term breastfeeding. We conclude that efforts to increase breastfeeding rates for African American women and promote culturally sensitive interventions must address underlying socioeconomic and structural barriers, women’s perceptions of breastfeeding benefits and difficulties, and the need for improvements in postnatal lactation and doula support to foster a more inclusive culture of breastfeeding.

KEYWORDS:

• Infant feeding
• breastfeeding
• ethnic disparities
• perinatal care
• African American women
• doulas

Acknowledgments

The authors would like to thank the staff and women participants at the clinic, hospital, and doula program and Tampa Bay Breastfeeding Task Force for their support and participation in this project, and Melina Taylor for editorial assistance.

Conflict of Interest

The authors declare that they have no conflict of interest.

Notes

1. Pseudonyms are used for the clinic name and all study participants.

Additional information

Funding

This research was supported by a Research Matters grant (2015) from the Office of Community Engagement and Partnerships at the University of South Florida, Tampa, FL and Tampa General Hospital Foundation.