title: Reasons for Infant Feeding Decisions in Low-Income Families in Washington, DC.
abstract: BACKGROUND
  Breastfeeding rates for low-income, African American infants remain low.
  
  
  OBJECTIVE
  This study aimed to determine the barriers, support, and influences for infant feeding decisions among women enrolled in the Washington, DC, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) after revisions in the WIC package to include more food vouchers for breastfeeding mothers and their infants and improvement of in-hospital breastfeeding support.
  
  
  METHODS
  We surveyed 100 women, using a 42-item verbally administered survey that asked about demographics, infant feeding method, and influences and support for feeding decisions.
  
  
  RESULTS
  The majority of participants (76%) initiated breastfeeding; 31% exclusively breastfed in the hospital. Participants were more likely to breastfeed if they had some college education, were unemployed or employed full-time, had only one child, and had been breastfed themselves as infants. Barriers to prolonged breastfeeding included limited support after hospital discharge, pain, and perceived insufficient milk supply. Participants in this study had higher breastfeeding initiation and in-hospital exclusivity rates after improvement of in-hospital breastfeeding support.
  
  
  CONCLUSIONS
  Clients of WIC initiated breastfeeding at a high rate but either supplemented with formula or stopped breastfeeding for reasons that could be remedied by improved prenatal education, encouragement of exclusive breastfeeding in the hospital, and more outpatient support.
authors.affiliation: 1 George Washington University, Milken Institute School of Public Health, Washington, DC, USA.
authors.forename: Onize
authors.initials: O
authors.lastname: Oniwon
authors.affiliation: 2 Children's National Health System and George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
authors.forename: Jennifer A F
authors.initials: JA
authors.lastname: Tender
authors.affiliation: 3 Children's National Health System, Washington, DC, USA.
authors.forename: Jianping
authors.initials: J
authors.lastname: He
authors.affiliation: 1 George Washington University, Milken Institute School of Public Health, Washington, DC, USA.
authors.forename: Elyshe
authors.initials: E
authors.lastname: Voorhees
authors.affiliation: 4 University of Virginia School of Medicine, Charlottesville, VA, USA.
authors.forename: Rachel Y
authors.initials: RY
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data*; D004219:District of Columbia / Q000208:ethnology; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000191:economics* / Q000600:supply & distribution; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty / Q000208:ethnology / Q000523:psychology; D012923:Social Class; D011795:Surveys and Questionnaires
keywords: African Americans; Infants; Special Supplemental Nutrition Program for Women; and Children; breastfeeding; breastfeeding barriers; breastfeeding cessation; breastfeeding support; decision making