Sex Differences in the Social Ecology of Breastfeeding: A Mixed Methods Analysis of the Breastfeeding Views of Expectant Mothers and Fathers in the Us Exposed to Adversity

Abstract

Despite the significant health benefits of breastfeeding for the mother and the infant, economic class and race disparities in breastfeeding rates persist. Support for breastfeeding from the father of the infant is associated with higher rates of breastfeeding initiation. However, little is known about the factors that may promote or deter father support of breastfeeding, especially in fathers exposed to contextual adversity such as poverty and violence. Using a mixed methods approach, the primary aims of the current work were to (1) elicit, using qualitative methodology, the worries, barriers and promotive factors for breastfeeding that expectant mothers and fathers identify as they prepare to parent a new infant, and (2) to examine factors that influence the parental breastfeeding intentions of both mothers and fathers using quantitative methodology. A sample (N=95) of expectant, third trimester mothers and fathers living in a low-income, urban environment in Midwestern USA, were interviewed from October 2013 to February 2015 about their infant feeding intentions. Compared with fathers, mothers more often identified the benefits of breastfeeding for the infant’s health and the economic advantage of breastfeeding. Mothers also identified more personal and community breastfeeding support resources. Fathers viewed their own support of breastfeeding as important but expressed a lack of knowledge about the breastfeeding process and often excluded themselves from discussions about infant feeding. The results point to important targets for interventions that aim to increase breastfeeding initiation rates in vulnerable populations in the US by increasing father support for breastfeeding.

Reimagining Racial Trauma as a Barrier to Breastfeeding Versus Childhood Trauma and Depression Among African American Mothers

“…Use of assessment tools that help center the voice and needs of African American women and help clinicians develop critical understanding of the intersectional dynamic of family history, historical and current trauma, and oppression and discrimination should be considered. 45 Furthermore, sufficient evidence supports that engaging members of the mothers' interpersonal and broader community, including babies' fathers 47 and other social support figures, promote breastfeeding positively. 48 Culturally responsive family-and women-targeted programs that build breastfeeding self-efficacy 49 and provide critical psychosocial support are established in many black communities and considered essential support.…”

Examining Supports and Barriers to Breastfeeding through a Socio-Ecological Lens: A Qualitative Study

“…Despite the signi cant health bene ts, breastfeeding rates are still well-below the recommended duration of exclusive breastfeeding for at least the rst 6 months of life [4][5][6][7][8]. Research suggests that concurrent intervention delivery using a combination of systems such as home, family, healthcare and community involvement improves breastfeeding rates; however, few successful interventions are currently in practice [9].…”

Examining Supports and Barriers to Breastfeeding through a Socio-Ecological Lens: A Qualitative Study

“…Further, breastfeeding mothers have a lower risk of type 2 diabetes, hypertension, breast and ovarian cancer [3]. Despite the signi cant health bene ts, breastfeeding rates are still well-below the recommended duration of exclusive breastfeeding for at least the rst 6 months of life [4][5][6][7][8]. Research suggests that concurrent intervention delivery using a combination of systems such as home, family, healthcare and community involvement improves breastfeeding rates; however, few successful interventions are currently in practice [9].…”