title: Integrative Literature Review of Factors Related to Breastfeeding in African American Women: Evidence for a Potential Paradigm Shift.
abstract: BACKGROUND
  Human milk has widespread health benefits for infants, mothers, and society. However, not all populations of women, particularly African American women, engage in human milk feeding at high rates. Research aim: The purpose of this integrative literature review is twofold: (a) to examine factors that influence low rates of human milk feeding among African American women and (b) to introduce a need for a methodological paradigm shift to develop culturally relevant and effective interventions.
  
  
  METHODS
  The authors searched four electronic social science databases for peer-reviewed journal articles pertaining to human milk among African American women published from 1990 to 2015. Both coauthors independently assessed these articles using thematic analysis and validation. The database search yielded 47 peer-reviewed articles.
  
  
  RESULTS
  Three main themes emerged explaining the human milk feeding disparity: (a) the social characteristics of women likely not to feed human milk (e.g., low socioeconomic status, single); (b) women's perceptions of human milk feeding; and (c) the quality of human milk feeding information provided by health care providers (i.e., limited human milk information).
  
  
  CONCLUSIONS
  Current literature does include sociohistorical factors that have shaped current norms. Adding sociohistorical frameworks, paying particular attention to the embodied experience of historical trauma, could lead to the development of new evidence-based, culturally sensitive interventions to enhance human milk feeding in the African American community.
authors.affiliation: 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: DeVane-Johnson
authors.affiliation: 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Woods-Giscombé
authors.affiliation: 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Thoyre
authors.affiliation: 1 School of Nursing, University of North Carolina at Chapel Hill, Durham, NC, USA.
authors.forename: Cathie
authors.initials: C
authors.lastname: Fogel
authors.affiliation: 2 African American and Diaspora Studies, University of North Carolina at Chapel Hill, Durham, NC, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008895:Milk, Human; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010465:Perception; D012923:Social Class
keywords: African American; Black; attitudes; beliefs; bottle feeding; breastfeeding