Multilevel Factors Influencing Young Mothers’ Breastfeeding: A Qualitative CBPR Study

Abstract

Background: Young mothers (age 14–24 years), who are often low income, are less likely than other mothers to breastfeed for 6 months. They also are more likely to be diagnosed with aggressive forms of breast cancer; breastfeeding significantly reduces this risk. While adolescent breastfeeding has been investigated from the perspective of the individual, the social ecological model recognizes the influence of factors at multiple levels. Research aim: The aim was to identify social and structural barriers to and motivators of breastfeeding that young mothers may encounter. Methods: Using a cross-sectional prospective qualitative design with a community-based participatory research approach, we sought to identify influential factors at each social ecological level: individual, relationship, community, and societal/structural. We used purposeful sampling, and enlisted snowball sampling. We interviewed stakeholder experts (n = 9) and dyads (n = 6) consisting of a young mother and her decision-making partner. Groups of young mothers (n = 6 groups) collectively created community maps while discussing their feelings about infant feeding in different locations. Using collaborative data analysis, we identified themes and categorized barriers and facilitators according to the social ecological levels. Results: Four meta-themes emerged: roles, place, stigma, and support. While some barriers and facilitators were similar to those experienced by mothers of all ages, participants reported multiple overlapping stigmas, requiring more support. Conclusion: Young mothers who decide to breastfeed encounter barriers at multiple levels. Policies and programs aiming to increase breastfeeding rates in this group must address these barriers and enlist identified facilitators.

The Role of Stress in Breast Cancer Incidence: Risk Factors, Interventions, and Directions for the Future

“…Partnering with the community can create a path to effective cancer interventions by centering the topics that are of interest to the community and incorporating community knowledge [76]. One example is partnering with the community to investigate factors that promote or inhibit breastfeeding among young mothers [77]. In this instance, the partnership surfaced specific barriers such as stigma that can impact breastfeeding of young mothers but may not be an issue for all groups of mothers equally.…”

Exclusive breastfeeding among Saudi mothers: Exposing the substantial gap between knowledge and practice

“…[8] Regionally, breastfeeding behavior was also largely influenced by knowledge about the benefits associated with it. [9] Locally, in contrast, lack of support was cited as one of the important reasons for such low rates of exclusive breastfeeding among Saudi mothers, in addition to a multitude of biological (for instance, chronic diseases and obesity) and cultural factors. [10] Indeed, wider between-pregnancy intervals, husband and family support, and vaginal delivery are positive correlates with breastfeeding.…”

Growth and Change in the Journal of Human Lactation: A Content Analysis 1985–2018

“…JHL published two studies using the positive deviance theory with African American women (Barbosa, Masho, Carlyle, & Maosavel, 2016; Gross, Davis, Anderson, Hall, & Hilyard, 2017). The community participatory approach was the topic of a special issue in 2015 (Table 4) and continues to be used by researchers publishing in JHL ( Chopel et al, 2019).…”