title: Breastfeeding in African Americans may not depend on sleep arrangement: a mixed-methods study.
abstract: BACKGROUND
  Despite high bedsharing rates, breastfeeding rates are low among African Americans.
  
  
  OBJECTIVE
  Describe the association between breastfeeding and bedsharing; elucidate barriers to breastfeeding in African Americans.
  
  
  METHODS
  African American mothers with infants <6 months were recruited for this cross-sectional, mixed-methods study and completed an infant care practices survey. A subgroup participated in focus groups or individual interviews.
  
  
  RESULTS
  A total of 412 completed the survey; 83 participated in a focus group or interview. Lower socioeconomic status mothers were more likely to breastfeed exclusively or at all if they bedshared (P = .02 and P = .01, respectively). Bedsharing was not associated with breastfeeding among higher socioeconomic status mothers. Breast pain, lack of support, and maternal skepticism about breastfeeding benefits were barriers; the latter was a recurrent theme among nonbreastfeeding mothers.
  
  
  CONCLUSIONS
  While bedsharing is associated with breastfeeding in lower socioeconomic groups, it is not in higher socioeconomic African American groups. Skepticism about breastfeeding benefits may contribute to low breastfeeding rates in African Americans.
authors.affiliation: Children's National Health System, Washington, DC, USA.
authors.forename: Ashaini
authors.initials: A
authors.lastname: Kadakia
authors.affiliation: Children's National Health System, Washington, DC, USA.
authors.forename: Brandi
authors.initials: B
authors.lastname: Joyner
authors.affiliation: Children's National Health System, Washington, DC, USA George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tender
authors.affiliation: Children's National Health System, Washington, DC, USA.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Oden
authors.affiliation: Children's National Health System, Washington, DC, USA George Washington University School of Medicine and Health Sciences, Washington, DC, USA rmoon@cnmc.org.
authors.forename: Rachel Y
authors.initials: RY
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000379:methods / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000379:methods / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data; D012890:Sleep; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: bedsharing; breastfeeding; socioeconomic status; sudden infant death syndrome