Voices of low SES women overcoming breastfeeding barriers: A qualitative analysis and model development

Abstract

Background: Breast milk provides optimal nutrition for most infants for a specific amount of time. In spite of well-accepted benefits associated with breastfeeding, both for infants and mothers, rates among low-income women remain consistently low.

Objective: The objective of this study was to identify what motivates women, who are at a high risk of not initiating breastfeeding or early weaning, to establish a successful breastfeeding relationship.

Methods: Mothers meeting the eligibility criteria of having no more than a high school degree, being low-income, and having breastfed for > 3 weeks, completed an in-depth telephone interview. Using grounded-theory methodology, researchers developed a theoretical model describing the experience of this population.

Results: Though recruitment was ongoing for over a year, with 212 mothers screened for eligibility, only seven mothers were eligible and completed study activities. Based on analysis of interview transcripts, a theoretical model was developed.

Conclusions: Mothers who breastfeed despite being high-risk for not breastfeeding may be motivated by the perception that breastfeeding is easier than formula feeding and comforting. In addition, the breastfeeding relationship may be protected by the services offered by WIC, which may be amplified by the mother’s own determination. A lack of experienced barriers and the act of bed-sharing may also assist with breastfeeding duration. The researchers hypothesize that, as barriers are experienced that are beyond the perceived control of WIC services, the mother’s level of stress may increase, increasing the likelihood of weaning. Future research should test the proposed model and determine specific messages targeting this at-risk population.