Abstract:Objective: To explore issues related to initiating and sustaining breastfeeding in African American women.Design: Qualitative design using focus groups, guided by Leininger's theory of culture care diversity and universality.Setting: Three different regions of a southeastern state in the United States.Participants: Fifteen self-identified African American women who had recently breastfed were recruited by lactation consultants and by word of mouth.Methods: Three focus groups were conducted with initial guiding questions. New ideas that emerged were fully explored in the group and included as a guiding question for the next group.Results: Categories identified from the data were reasons to start and stop breastfeeding, advice about breastfeeding that was useful or not useful, and cultural issues related to breastfeeding that were perceived to be unique among African Americans. Three overall themes were identified that cut across categories: perceived lack of information about benefits and management of breastfeeding, difficulties breastfeeding in public, and lack of a support system for continued breastfeeding. Conclusion:Women need to be taught early in their pregnancies about the benefits of breastfeeding and offered continuing support and teaching once breastfeeding is established. Peer support groups for breastfeeding African American women should be established.

The purpose of this study was to examine how culture influenced breast-feeding decisions in African American and white women, using the Theory of Culture Care Diversity and Universality as a framework. One hundred eighty-six participants responded to the following: The word culture means beliefs and traditions passed down by your family and friends. How has culture affected how you plan to feed your baby? Qualitative content analysis was used to analyze the data. Four categories of responses were identified: influences of family, known benefits of breast-feeding, influences of friends, and personal choice. The findings suggest that race alone may not be as influential in infant feeding decisions as other factors. Although some women acknowledged the effect of their cultural background and experiences, most women reported that their culture did not affect their infant feeding decision. In this population, breast-feeding decisions were based on the influences of family, friends, self, and the perceived knowledge of breast-feeding benefits. Although breast-feeding statistics are commonly reported by race, cultural influences on infant feeding decisions may transcend race and include the influence of family and friends, learned information from impersonal sources, and information that is shared and observed from other people.