title: A qualitative study to understand cultural factors affecting a mother's decision to breast or formula feed.
abstract: BACKGROUND
  The presence of barriers is not sufficient to explain breastfeeding rate disparities. A relatively unexplored area in coping with breastfeeding barriers is culture.
  
  
  OBJECTIVE
  This research aims to better understand the role of culture in a woman's infant feeding decision by using race and socioeconomic status as indicators of culture.
  
  
  METHODS
  Focus groups and individual interviews were conducted with 42 pregnant women or mothers of infants younger than 12 months. Focus group composition was determined by self-identified African American or white race and self-reported eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or ineligibility (non-WIC).
  
  
  RESULTS
  Most participants acknowledged that breastfeeding was best, yet differences arose between groups in the perception of, and reaction to, breastfeeding barriers. WIC and non-WIC participants of both races indicated that some circumstances necessitated formula use. WIC participants felt that this was personally and socially acceptable due to need, whereas non-WIC participants felt that this was personally and socially unacceptable. When a barrier arose, WIC participants of both races felt that the infant feeding choice was not theirs and formula use might be inevitable. In contrast, non-WIC participants of both races expressed that they persevered to continue breastfeeding and did so by establishing small, achievable goals and seeking mentors.
  
  
  CONCLUSIONS
  Educational and public health efforts to reduce breastfeeding disparities may be enhanced if support is tailored to acknowledge cultural differences among women and address factors that make either breastfeeding or formula feeding acceptable, or even preferable, within their communities.
authors.affiliation: 1Michigan State University, East Lansing, MI, USA.
authors.forename: Tara P
authors.initials: TP
authors.lastname: Fischer
authors.forename: Beth H
authors.initials: BH
authors.lastname: Olson
mesh_terms: D001741:Black or African American / Q000523:psychology; D001942:Breast Feeding / Q000191:economics / Q000208:ethnology / Q000523:psychology*; D003466:Cultural Characteristics; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000592:standards; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000191:economics; D007231:Infant, Newborn; D008895:Milk, Human; D009035:Mothers / Q000523:psychology*; D010465:Perception; D011247:Pregnancy; D011632:Public Assistance / Q000706:statistics & numerical data; D036301:Qualitative Research; D044465:White People / Q000523:psychology
keywords: breastfeeding; breastfeeding attitudes; breastfeeding beliefs; culture; formula feeding; infant feeding; race; socioeconomic status