title: Deaf mothers and breastfeeding: do unique features of deaf culture and language support breastfeeding success?
abstract: BACKGROUND
  Deaf mothers who use American Sign Language (ASL) consider themselves a linguistic minority group, with specific cultural practices. Rarely has this group been engaged in infant-feeding research.
  
  
  OBJECTIVE
  To understand how Deaf mothers who use ASL learn about infant feeding and to identify their breastfeeding challenges.
  
  
  METHODS
  Using a community-based participatory research approach, we conducted 4 focus groups with Deaf mothers who had at least 1 child 0-5 years old. A script was developed using a social ecological model (SEM) to capture multiple levels of influence. All groups were conducted in ASL, filmed, and transcribed into English. Deaf and hearing researchers analyzed data by coding themes within each SEM level.
  
  
  RESULTS
  Fifteen mothers participated. All had initiated breastfeeding with their most recent child. Breastfeeding duration for 8 of the mothers was 3 weeks to 12 months. Seven of the mothers were still breastfeeding, the longest for 19 months. Those mothers who breastfed longer described a supportive social environment and the ability to surmount challenges. Participants described characteristics of Deaf culture such as direct communication, sharing information, use of technology, language access through interpreters and ASL-using providers, and strong self-advocacy skills. Finally, mothers used the sign for "struggle" to describe their breastfeeding experience. The sign implies a sustained effort over time that leads to success.
  
  
  CONCLUSIONS
  In a setting with a large population of Deaf women and ASL-using providers, we identified several aspects of Deaf culture and language that support breastfeeding mothers across institutional, community, and interpersonal levels of the SEM.
authors.affiliation: 1Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Chin
authors.forename: Jessica
authors.initials: J
authors.lastname: Cuculick
authors.forename: Matthew
authors.initials: M
authors.lastname: Starr
authors.forename: Tiffany
authors.initials: T
authors.lastname: Panko
authors.forename: Holly
authors.initials: H
authors.lastname: Widanka
authors.forename: Ann
authors.initials: A
authors.lastname: Dozier
mesh_terms: D001942:Breast Feeding; D002675:Child, Preschool; D003142:Communication; D055812:Community-Based Participatory Research; D054521:Cultural Competency; D017144:Focus Groups; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology*; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D012813:Sign Language
keywords: American Sign Language; Deaf; breastfeeding; breastfeeding practices; cultural norms; language