Abstract
Background
In Washington, DC, African American women receiving the Special Supplemental Nutrition
Program for Women, Infants and Children (WIC) benefits have the lowest breastfeeding
rates compared with other WIC-eligible populations.
Objectives
The purpose of this research was to use the social cognitive theory and elements of
social support as a guiding framework to better understand the factors affecting breastfeeding
initiation and duration among African American WIC recipients in low-income areas
of Washington, DC.
Methods
Semistructured interviews were conducted with 24 women receiving WIC services in DC
to learn about their infant feeding practices and decisions. Using a pragmatic approach,
an integrated inductive and deductive coding strategy was used.
Results
Breastfeeding experiences were influenced by barriers at multiple levels: community
(i.e., perceptions of breastfeeding in one's network), interpersonal (i.e., few supportive
providers), and individual constraints (i.e., pain, supply, and latching issues) as
well as environmental difficulties of finding resources to help overcome these challenges.
Social support from a close family member, friend, or partner often helped to minimize
many of these barriers and facilitated breastfeeding.
Conclusions
Social support seems to bolster efficacy and help women to overcome various barriers
to breastfeeding in their immediate environment; however, social support from providers
was limited. WIC offers recipients in DC many helpful breastfeeding resources. Although
several respondents were aware of these resources, overall use in the sample was low.
Continued outreach may help further facilitate breastfeeding in African American mothers
by providing additional sources of social support.
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Biography
Jennifer Schindler-Ruwisch, DrPH, is currently an Assistant Professor at Fairfield University. She has special interest in nutrition-related diseases, smoking cessation, and maternal/child health. She is passionate about decreasing health disparities and social/environmental determinants of health.
Biography
Amira Roess, PhD, is an Associate Professor at the George Washington University Milken Institute School of Public Health. She is engaged in mixed-methods to conduct emerging infectious and zoonotic disease research, emergency preparedness and response, HIV/AIDS research, and mHealth technology integration and evaluation.
Biography
Rebecca C. Robert, PhD, is an Assistant Professor in the Conway School of Nursing, The Catholic University of America. She focuses on community-based research to improve infant and young child feeding and nutrition in the U.S. and globally.
Biography
Melissa Napolitano, PhD, is a Professor at the George Washington University Milken Institute School of Public Health. She adapts face-to-face treatment content for dissemination via different delivery channels. Her work specifically focuses on physical activity promotion, weight loss, and prevention of weight gain.
Biography
Emily Woody, MPH, RDN, IBCLC, is a Registered Dietician and Certified Lactation Consultant. Ms. Woody is currently the Breastfeeding Coordinator for the WIC State Agency for the District of Columbia WIC State Agency, District of Columbia Department of Health (DOH).
Biography
Paulette Thompson, MSN, RDN, is a Registered Dietitian and a Certified Lactation Specialist. Ms. Thompson was a Supervisory Public Health Nutrition/Nutrition Education Coordinator for the WIC State Agency for the District of Columbia Department of Health (DOH). She retired from the DC Government in 2018.
Biography
Vinu Ilakkuvan, DrPH, is Founder and Principal Consultant of PoP Health, LLC, a consulting practice focused on strengthening multi-sector community partnerships that address social determinants of health. She is also a Professorial Lecturer at the George Washington University Milken Institute School of Public Health.
Article info
Publication history
Published online: August 10, 2019
Accepted:
July 15,
2019
Received in revised form:
July 5,
2019
Received:
March 21,
2019
Footnotes
Supported by the Clara Schiffer Fellowship and the George Washington School of Public Health Dissertation Research Award.
Identification
Copyright
© 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.
