Sociocultural Barriers to Breast Feeding in African American Women with Focused Intervention to Increased Prevalence

Objective: The goal of this study is to uncover sociocultural barriers to breastfeeding among African American women in the Atlanta metropolitan area and provide an educational intervention based on identified barriers to increase the willingness to breastfeed. Methods: Non-Hispanic African American women, 6 to 9 months pregnant, between the ages of 18 and 45, of varying socioeconomic status were recruited from multiple Obstetrics and Gynecology clinics throughout the Atlanta-metropolitan area. Participants completed a self-administered pre-test survey that questioned their intention to breastfeed and anticipated barriers associated with breastfeeding. Those who were unsure of breastfeeding or did not plan to breastfeed were asked to participate in an educational intervention that provided information about breastfeeding, the benefits to mother and baby and managing commonly perceived barriers. Immediately after the intervention a post-test was provided. A second post-test was conducted after all participants delivered their baby. Chi-square analysis was performed to examine the distribution of actual breastfeeding initiation rates by initial intention as well as by age, income and education. Results: Forty-nine women participated in the study. 18 of 20 women (90%) who intended to exclusively breastfeed initiated breastfeeding. Sixteen women reported that they did not intend to breastfeed. After receiving the intervention, 56.3% (n=9) initiated breastfeeding. Thirteen women reported they were unsure of their feeding plans in the pretest. Of these, 69.2% (n=9) initiated breastfeeding. Participants reported their primary barriers to breastfeeding were fear of pain, difficulty breastfeeding once they returned to work and lack of support from family, friends and their partner/spouse/father of the child. A significant association was observed between ages 25-29 years old and initiation of breastfeeding in women who were unsure of their breastfeeding plans (p=0.005). No association was found between income or education and initiation of breastfeeding. Conclusion: Education about breastfeeding was a significant barrier to breastfeeding in the African-American women in our study population. Women who participated in the intervention were more likely to initiate breastfeeding. Employment status, income, and education were not significant factors in a woman’s decision to initiate breastfeeding