title: Exploring intended infant feeding decisions among low-income women.
abstract: BACKGROUND
  Low-income women have the lowest rates of breastfeeding in the United States. Greater understanding of factors that predict intention to feed artificial breastmilk substitute is needed to inform the design and timing of interventions to promote breastfeeding among vulnerable women. This study aimed to identify demographic and reproductive characteristics and other factors associated with intent to feed artificial breastmilk substitute among low-income women.
  
  
  METHODS
  Data from 520 low-income women interviewed at 24-41 weeks of gestation during enrollment in a prenatal breastfeeding education intervention study were analyzed. Participant characteristics, reasons for feeding decision, and sources and types of information received were compared among women intending to feed only artificial breastmilk substitute and other women.
  
  
  RESULTS
  Most participants (95%) had already chosen an infant feeding method at the time of interview. There were no differences in plans to return to work by feeding plan. Women reporting intention to feed only artificial breastmilk substitute were less likely to report receiving information about the benefits of breastfeeding, how to breastfeed, and pumps and were more likely to cite personal preference and convenience as reasons for their decision. Women were more likely to intend to feed artificial breastmilk substitute if they had a previous live birth or had not breastfed a child, including the most recent.
  
  
  CONCLUSIONS
  These findings suggest breastfeeding promotion should target women early and include sensitive, effective ways to promote breastfeeding among women who have not previously successfully breastfed. Breastfeeding history should be elicited, and plans to pump should be supported prenatally.
authors.affiliation: 1 Department of Epidemiology, West Virginia University , Morgantown, West Virginia.
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Gurka
authors.forename: Paige P
authors.initials: PP
authors.lastname: Hornsby
authors.forename: Emily
authors.initials: E
authors.lastname: Drake
authors.forename: Evan M
authors.initials: EM
authors.lastname: Mulvihill
authors.forename: Emily N
authors.initials: EN
authors.lastname: Kinsey
authors.forename: Miheret S
authors.initials: MS
authors.lastname: Yitayew
authors.forename: Claire
authors.initials: C
authors.lastname: Lauer
authors.forename: Sharon
authors.initials: S
authors.lastname: Corriveau
authors.forename: Valerie
authors.initials: V
authors.lastname: Coleman
authors.forename: Guari
authors.initials: G
authors.lastname: Gulati
authors.forename: Ann L
authors.initials: AL
authors.lastname: Kellams
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data; D002755:Choice Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D033182:Intention; D008425:Maternal Behavior; D009035:Mothers / Q000523:psychology; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014931:Women, Working / Q000523:psychology