Determinants of Breastfeeding Initiation and Duration Among African American DC WIC Recipients: Perspectives of Recent Mothers

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.