Reflections of Black Women Who Choose to Breastfeed:  Influences, Challenges and Supports.
OBJECTIVE
Black women continue to have the lowest rates of breastfeeding. Of those who choose to breastfeed up to half cease nursing within the first few days or months postpartum. This study identified factors that influence and challenge Black women who choose to breastfeed, and supportive strategies that facilitate successful breastfeeding experiences.


METHODS
Four focus groups were conducted in 2013 with 16 self-identified Black women aged 21-46 (M = 31.35 years), with 11-18 (M = 14.94) years of education, and were either pregnant or had given birth to an infant within the prior 5 years (range of pregnancies 1-7; M = 2.44). A standard set of questions guided discussions. Data saturation occurred after three groups. All discussions were audiotaped and transcribed. Qualitative methods were used to identify categories and subthemes. Reviewers met periodically to resolve ambiguities and coding discrepancies. Member checking was conducted.


RESULTS
Four major categories emerged: Balancing the influences: People, myths, and technology; Being in the know; Critical periods; and, Supportive Transitions. Most women experienced little help with breastfeeding from health providers or systems. More influential was the interplay of family members,myths and the internet "as my friend". Role models and personalized support were noted as important but lacking among Black women. Patient profiling, experienced by some of the women, impacted breastfeeding choices.


CONCLUSIONS
Black women such as our participants are critical partners as we develop systems of care to decrease disparities and increase Black women's successes in breastfeeding. Findings underscore the importance of having diverse, readily available, user-friendly, culturally sensitive options for Black women who choose to breastfeed.
Melanie
M
Lutenbacher
Sharon M
SM
Karp
Elizabeth R
ER
Moore
D000328:Adult; D001741:Black or African American; D044383:Black People / Q000523:psychology*; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011247:Pregnancy; D011295:Prenatal Care; D036301:Qualitative Research; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires