title: Long-Term Breastfeeding in African American Mothers.
abstract: BACKGROUND
  According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach.
  
  
  METHODS
  African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software.
  
  
  RESULTS
  Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media.
  
  
  CONCLUSIONS
  Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.
authors.affiliation: 1 Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA.
authors.forename: Tyra Toston
authors.initials: TT
authors.lastname: Gross
authors.affiliation: 2 Department of Health Promotion and Behavior, University of Georgia, Athens, GA, USA.
authors.forename: Marsha
authors.initials: M
authors.lastname: Davis
authors.affiliation: 3 Department of Foods and Nutrition, University of Georgia, Athens, GA, USA.
authors.forename: Alex K
authors.initials: AK
authors.lastname: Anderson
authors.affiliation: 4 Department of Lifelong Education, Administration, and Policy, University of Georgia, Athens, GA, USA.
authors.forename: Jori
authors.initials: J
authors.lastname: Hall
authors.affiliation: 5 Social Marketing and Communication, FHI 360, Atlanta, GA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Hilyard
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000208:ethnology / Q000523:psychology; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D063105:Food Assistance / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D036301:Qualitative Research; D012923:Social Class; D013997:Time Factors; D014481:United States / Q000208:ethnology
keywords: Infants; Special Supplemental Nutrition Program for Women; and Children; breastfeeding; breastfeeding duration; breastfeeding experience; qualitative methods