Against the Odds: Breastfeeding Experiences of Low Income Mothers

Raisler, Jeanne

doi:10.1016/s1526-9523(00)00019-2

Cited by 97 publications

(136 citation statements)

References 25 publications

Supporting

Mentioning

131

Contrasting

Order By: Relevance

“…Also, breastfeeding initiation increased nearly 5-fold among black women and nearly 11-fold among single women. Raisler et al 34 found similar results from focus group interviews with low-income mothers who reported that the personal contact with a health care provider was more effective than written information or videos.…”

Section: Figurementioning

confidence: 76%

Lactation Counseling for Mothers of Very Low Birth Weight Infants: Effect on Maternal Anxiety and Infant Intake of Human Milk

Sisk¹,

Lovelady²,

et al. 2006

View full text Add to dashboard Cite

OBJECTIVE. Although it is well documented that breastfeeding promotes health and development of very low birth weight (VLBW) infants, lactation initiation among mothers of VLBW infants is low. Mothers are anxious about the health of their children, and medical staff may be reluctant to promote breastfeeding out of concern for increasing that anxiety. Therefore, the purpose of this study was to examine whether mothers of VLBW infants who initially planned to formula feed were different in terms of their level of anxiety and maternal stress compared with mothers who had planned to breastfeed their infants. The aims of this study were to (1) determine whether counseling mothers of VLBW infants who had initially planned to formula feed on the benefits of breast milk would increase their stress and anxiety levels, (2) assess whether mothers who initially had not planned to breastfeed changed their plans after counseling to provide breast milk, and (3) measure the amount of breast milk expressed by mothers who initially planned to formula feed. Their results were compared with those of mothers of VLBW infants who initially planned to breastfeed. METHODS. Initial plan to breastfeed (initial breastfeed group [IBG]; n = 115) or formula feed (initial formula feed group [IFG]; n = 81) was determined before counseling. All participants received counseling on infant health benefits, collection and storage of breast milk, and breast pump procurement. Maternal anxiety was measured using the State-Trait Anxiety Inventory (STAI), which was administered to mothers before and after counseling and every 2 weeks until infant discharge. Maternal stress was measured after counseling with the Parental Stressor Scale: NICU. Infant breast milk intake was measured throughout hospitalization. An exit questionnaire that pertained to the perceived benefits and efforts of expressing milk was administered close to the time of infant discharge. RESULTS. After lactation counseling, 100% of the IBG and 85% of the IFG initiated breast milk expression (used the electric breast pump in the hospital) for a total lactation initiation rate of 94%. After adjustment for the mothers who initiated milk expression but did not provide any breast milk, the lactation initiation rate for the entire group was 84%. Non-Hispanic black mothers and Non-Hispanic white mothers initiated milk expression at similarly high rates (95% vs 93%). Also, milk expression initiation was similar for low-income and non–low-income mothers (95% vs 92%). IFG and IBG STAI and Parental Stressor Scale: NICU scores were not significantly different, and there were no significant differences between groups in the change in anxiety after counseling. In addition, the mean difference scores (after counseling − before counseling) for STAI anxiety “state” were not significantly different between groups, even when controlling for “trait” anxiety. State anxiety declined during the first 6 weeks of infant hospitalization in a similar manner for both groups. Maternal trait but not state anxiety scores were inversely correlated with total infant breast milk intake. Breast milk intake (mL/kg per day) was greater in the infants of mothers in the IBG compared with the IFG at each week during the first month and for their entire hospital stay. Infant breast milk intake increased from weeks 1 to 3 in both groups and continued to rise in the fourth week for the IBG. However, breast milk intake declined at week 4 for the IFG. IBG infants received breast milk for 83% of the total fed hospital days (days that feedings were given) compared with 44% of total fed days for the IFG. The proportion of enteral intake that was breast milk was also greater for the IBG compared with IFG during the first 4 weeks and for the total hospitalization. However, the mothers in IFG were able to provide at least 50% of their infants' enteral intake for the first 3 weeks, 48.8% for the fourth week, and 32.8% of the enteral intake for the entire hospitalization. Infants of low-income women received significantly lower amounts of breast milk than did infants of non–low-income mothers. Race and income accounted for 36% of the variance in breast milk intake. Of the 184 mothers who initiated breast milk expression, 72 (39%) completed the exit questionnaire. Infant health benefits were the most common reasons cited by both groups for expressing milk. The most common reasons that both groups reported for ceasing milk expression were (1) low milk supply, (2) returning to work or school, and (3) inability to pump as often as needed. Almost all of the mothers reported that pumping was worth the effort (IBG 100%, IFG 87%), and 100% said that they were glad that the staff helped them with milk expression. CONCLUSION. Counseling mothers of VLBW infants increases the incidence of lactation initiation and breast milk feeding without increasing maternal stress and anxiety.

show abstract

Section: Figurementioning

confidence: 76%

Lactation Counseling for Mothers of Very Low Birth Weight Infants: Effect on Maternal Anxiety and Infant Intake of Human Milk

Sisk¹,

Lovelady²,

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Results are consistent with previous research indicating that African American mothers often experienced differences in care from breastfeeding support professionals in ways that undermine and discourage their breastfeeding behavior. 19,50 These findings have implications for training healthcare providers to provide culturally appropriate care for increasingly diverse populations of mothers in ways that assure consistency and avoid racial bias in breastfeeding education.…”

Section: Local Implementation Of Institutional-level Interventions Anmentioning

confidence: 99%

Enhancing Breastfeeding Rates Among African American Women: A Systematic Review of Current Psychosocial Interventions

Johnson

Kirk

Rosenblum

et al. 2015

Breastfeeding Medicine

124

109

View full text Add to dashboard Cite

The goals of this article are to provide a review of key interventions and strategies that impact initiation and duration of breastfeeding with particular focus on low-income African American mothers' maternal psychological vulnerabilities during the early postpartum period using a social ecological perspective as a guiding framework. Although modest gains have been achieved in breastfeeding initiation rates in the United States, a projected gap remains between infant feeding practices and national Healthy People breastfeeding goals set for 2020, particularly among African Americans. These disparities raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes because of poorer mental health and increased vulnerability to chronic health conditions. Breastfeeding can be a protective factor, strengthening the relationship between mother and baby and increasing infant health and resilience. Evidence suggests that no single intervention can sufficiently address the multiple breastfeeding barriers faced by mothers. Effective intervention strategies require a multilevel approach. A social ecological perspective highlights that individual knowledge, behavior, and attitudes are shaped by interactions between the individual woman, her friends and family, and her wider historical, social, political, economic, institutional, and community contexts, and therefore effective breastfeeding interventions must reflect all these aspects. Current breastfeeding interventions are disjointed and inadequately meet all African American women's social and psychological breastfeeding needs. Poor outcomes indicate a need for an integrative approach to address the complexity of interrelated breastfeeding barriers mothers' experience across layers of the social ecological system.

show abstract

“…The reasons low-income women in general do not breastfeed and instead choose formula include the belief that breastfeeding is painful, the lack of a supportive environment, embarrassment about nursing in public, concern that breastfeeding is restrictive and inconvenient, and the need to return to work or school (Raisler, 2000). Women who initiate breastfeeding, but wean prematurely, often do so because of perceived inadequate milk supply, maternal fatigue, and sore nipples (Milligan, Pugh, Bronner, Spatz, & Brown, 2000).…”

Section: Breastfeeding Choices Of Low-income Mothersmentioning

confidence: 99%

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Gill

Reifsnider²,

Mann³

et al. 2004

jpe

View full text Add to dashboard Cite

Focus groups were conducted with low-income, pregnant women and new mothers receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) along with their male partners and their mothers. All participants were Hispanics of Mexican American origin. The topics for the focus-group discussions were breastfeeding beliefs and perceptions. All participants were aware of the benefits of breastfeeding. Participants identified time, embarrassment, and pain as barriers to breastfeeding; discussed decision-making efforts regarding breastfeeding; identified cultural beliefs related to breastfeeding; and discussed the lack of care-provider support for breastfeeding.

show abstract

Against the Odds: Breastfeeding Experiences of Low Income Mothers

Cited by 97 publications

References 25 publications

Lactation Counseling for Mothers of Very Low Birth Weight Infants: Effect on Maternal Anxiety and Infant Intake of Human Milk

Lactation Counseling for Mothers of Very Low Birth Weight Infants: Effect on Maternal Anxiety and Infant Intake of Human Milk

Enhancing Breastfeeding Rates Among African American Women: A Systematic Review of Current Psychosocial Interventions

Assessing Infant Breastfeeding Beliefs Among Low-Income Mexican Americans

Contact Info

Product

Resources

About