An ecological approach to breastfeeding.
OBJECTIVE
Current numbers of breast-feeding mothers are well below Healthy People 2010 goals of 75% in the early postpartum period, 50% at 6 months, and 25% at 1 year. A promising line of research is the use of an ecological model for breastfeeding that includes factors traditionally examined in breastfeeding (mother/infant and family) as well as mesosystem and exosystem sources of influence on families (healthcare delivery system, community, and societal/cultural).


METHODS
A telephone survey was conducted with 95 primiparous, postpartum women using closed and open-ended items. Content analysis was used with the transcribed comments from these telephone interviews, to test the fit of a preexisting ecological model for breastfeeding.


RESULTS
The comments of postpartum women provided a rich source of information about the many mother-infant, family, healthcare delivery system, community, and societal/cultural factors that influence breastfeeding. These all fit the ecological breast-feeding model proposed.


CONCLUSIONS
Efforts to improve rates of breastfeeding in this country to meet year 2010 goals must consider the many contextual factors that influence feeding. Interventions to promote breastfeeding should exceed the individual level, and occur at many layers simultaneously. The ecological model provides direction for the multiple interventions needed to increase rates and duration of breastfeeding.
Tiedje
Linda Beth
LB
Michigan State University, Department of Epidemiology, Lansing, MI 48823, USA. tiedje@pilot.msu.edu
Schiffman
Rachel
R
Omar
Mildred
M
Wright
Jackie
J
Buzzitta
Carol
C
McCann
Alyne
A
Metzger
Sandra
S
D001942:Breast Feeding; D004463:Ecology; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D008962:Models, Theoretical; D009034:Mother-Child Relations; D010353:Patient Education as Topic / Q000592:standards; D011787:Quality of Health Care; D012944:Social Support; D014481:United States