title: Cultural Norms in Conflict: Breastfeeding Among Hispanic Immigrants in Rural Washington State.
abstract: Objectives To examine perceptions, experiences, and attitudes towards breastfeeding among Hispanic women living in rural Washington State. Methods Twenty parous Hispanic women of low acculturation, aged 25-48 years and residents in rural Washington State participated in an exploratory, face-to-face interview. Interviews were audio-recorded, translated and transcribed, and analyzed using a thematic content analysis approach. Results Nine emergent themes were grouped into three overarching categories: (1) Breast is best; (2) Hispanic cultural and familial expectations to breastfeed; and (3) Adapting to life in the United States: cultural norms in conflict. Women said they were motivated to breastfeed because of their knowledge and observations of its health benefits for mother and child. They said breastfeeding is ingrained in their Hispanic cultural heritage, and infant feeding choices of female family members were particularly influential in women's own decision to breastfeed. Women said they experienced embarrassment about breastfeeding in the United States and as a result, often chose to initiate formula feeding as a complement so as to avoid feelings of shame. Additionally, they faced economic pressure to work, key barriers for continued breastfeeding among Hispanics in the United States. Conclusions for Practice Knowledge of the benefits of breastfeeding for mother and child and longstanding cultural practices of breastfeeding are not enough to encourage exclusive breastfeeding to 6 months among this rural Hispanic population. Continued support through family-level interventions as well as work place policies that encourage breastfeeding are needed for rural Hispanics to reach optimal breastfeeding rates.
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. shohl@fredhutch.org.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hohl
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.affiliation: Centro Para Promover la Salud Comunitaira, Fred Hutchinson Cancer Research Center, Sunnyside, WA, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Escareño
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Duggan
mesh_terms: D000069:Acculturation; D000328:Adult; D001942:Breast Feeding / Q000208:ethnology*; D002755:Choice Behavior; D054242:Emigrants and Immigrants / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008425:Maternal Behavior / Q000208:ethnology* / Q000523:psychology; D009034:Mother-Child Relations / Q000208:ethnology; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care / Q000379:methods* / Q000523:psychology; D012424:Rural Population; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014861:Washington; D055815:Young Adult
keywords: Breastfeeding; Health disparities; Hispanic/Latino; Immigrant health; Rural populations