Exploring Higher Rates of Breastfeeding Among Civilian Military Wives: A Mixed Methods Study

Abstract

Background: As compared to the United States general postpartum population, civilian military wives encounter unique challenges that can impede their ability to breastfeed, including geographic replacement and physical and emotional challenges. Yet despite these challenges, civilian military wives demonstrate higher rates of breastfeeding initiation and duration in the United States postpartum population as a whole. The purpose of this study was to explore factors contributing to the high rate of breastfeeding initiation and duration among civilian military wives and to determine what might be learned from these factors for intervention design for the broader population of postpartum mothers. Methods: The sample consisted of 28 civilian military wives whose ages ranged from 18-45. The study was conducted online using a concurrent mixed-methods design. Results: Seven main themes with 16 subthemes emerged from the descriptions of the semi-structured interviews. The results of the Breastfeeding Self-Efficacy Scale-Short Form score was 55.2 (SD = 5.73). The results of the integrative analysis revealed that factors within the military environment influence a sense of community, thus supporting their breastfeeding self-efficacy (BSE). Additionally, supportive and pro-breastfeeding healthcare facilitators (especially lactation consultants) throughout the prenatal, intrapartum, and postpartum periods described by civilian military wives were associated with high levels of breastfeeding self-efficacy among civilian military wives. Moreover, high levels of breastfeeding self-efficacy related to breastfeeding skills and duration were associated with the accessibility of resources within the military environment, breastfeeding health and economic benefits, and setting of a breastfeeding goal. Conclusions: Using a concurrent mixed-methods design, this study identified facilitators from the descriptions of civilian military wives that they believed promote their higher rates of breastfeeding initiation and continuation, quantified their high level of breastfeeding self-efficacy, and identified descriptive factors that contributed to both areas lacking in the literature among this population.