Ecological Factors Influencing Breastfeeding Decisions among Korean Immigrant Mothers in America

Client-Centered Breastfeeding-Promotion Strategies: Q Methodology

“…Breastfeeding rates are diverse by nation, culture, and ethnic group despite the ongoing efforts of the World Health Organization and UNICEF [ 3 , 8 , 35 ]. Some consider breastfeeding to be “old-fashioned”, while others view it as normative childrearing behavior [ 12 , 36 ]. Depending on the social context, higher education has served to promote breastfeeding (e.g., Korean-American women) [ 12 ] while also serving as a barrier (e.g., South Korean women) [ 30 ], which was reinforced by the present findings.…”

“…A dramatic decline in breastfeeding practice in Korea has occurred during the past few decades [ 11 , 12 , 13 ]. To promote breastfeeding, diverse efforts led by the government are continuous, such as education during the antenatal period emphasizing the advantages of breastfeeding, postpartum care service with lactation massage, and a government voucher for a certified postnatal care helper through a public-health center for any woman in need.…”

“…Previous research reports multiple factors contributing to the negative milieu toward initiating and continuing breastfeeding [ 15 , 16 ]. Barriers to breastfeeding on the policy level include an unsupportive policy of maternal and paternal leave before and after childbirth [ 12 , 15 ], the lack of adequate breastfeeding spaces in the workplace or in public sites that afford privacy [ 17 ], aggressive formula marketing by formula manufacturers, and an unsupportive environment for breastfeeding in healthcare facilities [ 18 ]. Obstacles on the sociocultural level include social norms against breastfeeding in public places [ 19 , 20 ] and incorrect beliefs toward colostrum [ 19 ].…”

“…Infant or maternal lactation issues also contribute to early discontinuation [ 16 , 21 ]. Additionally, concerns about older children, method of delivery [ 12 , 22 ], and the absence of partner and/or family support negatively influence breastfeeding practice [ 20 ].…”

“…Women do not automatically initiate and continue breastfeeding [ 12 , 23 ]. Rather, they voluntarily select breastfeeding on the basis of physical conditions, personal values, and social and cultural norms [ 23 , 24 ].…”