A Pilot Investigation of Infant

Feeding Preferences and

Attitudes Toward Breastfeeding
Among Pregnant African
American Women

September 25, 2015

13th Annual Research Symposium

Presented by

Tisha Felder, PhD, MSW

Assistant Professor
College of Nursing and Cancer Prevention and Control
Program, Arnold School of Public Health

Joynelle L. Rivers, EdD, MSN, RNC

Clinical Assistant Professor
College of Nursing

Jennifer Beecroft
Undergraduate Nursing Student
College of Nursing

Objectives
After the presentation, participants will be
able to:
1. Articulate public health recommendations
and goals for breastfeeding among U.S.
women.
2. Describe the racial/ethnic differences in
rates of breastfeeding among U.S.
women.
3. Understand cultural perspectives on and

Public Health
Recommendations

Infants should be exclusively

breastfed for 6 months, and following
introduction of solid foods, continued
breastfeeding for up to:
1 year (American Academy of
Pediatrics)

2 years or more (World Health

Organization)

African American women have the

lowest breastfeeding rates in the
U.S.

African Americans have even

lower breastfeeding rates in
South Carolina

South Carolina

Initiation,
% (95% CI)

6 months,
% (95% CI)

12 months,
% (95% CI)

187

76.7 (69.6-83.8)

46.4 (37.8--55.0)

21.8 (14.1-29.5)

White, nonHispanic

1,105

71.0 (67.7-74.3)

36.3 (33.0--39.6)

Black, nonHispanic

325

Hispanic

43.3 (37.2-- 15.9 (11.7--20.1)

49.4)

15.8 (13.4-18.2)
4.6 (2.1-7.1)

Prevalence of breastfeeding initiation and duration to 6

months and 12 months,* by state and race/ethnicity --National Immunization Survey, United States, 2004--2008
Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5911a2.htm

Why do fewer African

American women
breastfeed?
CULTURAL PERSPECTIVES
AND BARRIERS TO
BREASTFEEDING

USC Institute for African

American Research
Overall
goal: explore
the knowledge,
Fellowship
(2014-2015)

attitudes and perceptions of

pregnant African American women
and their partner/family members
toward breastfeeding and potential
methods for promoting breastfeeding
among this population.
Phase I: Survey research

Study Methods
Study participants &
recruitment (Apr
June 2015)
Eligibility:

Self-identify as African
American or Black
18 years or older
Resident of South
Carolina
Pregnant
English-speaking

Recruited from
Palmetto Health
Womens Clinic

Survey
Self-administered
questionnaire (15
questions)
socio-demographics
maternal history
17-item Iowa Infant
Feeding Attitude Scale
(IIFAS)

Iowa Infant Feeding Attitude

Scale
Example items from The Iowa Infant Feeding Attitude
Scale
The nutritional benefits of breast milk last only until the baby
is weaned from breast milk.
Formula-feeding is more convenient than breastfeeding.
Formula feeding is the better choice if a mother plans to work
outside the home.
Women should not breastfeed in public places such as
restaurants.
Assesses
Fathers
feel leftknowledge,
out if a mother
attitudes
breastfeeds.
and beliefs toward
breastfeeding
Validated, copyrighted, and commonly used in
breastfeeding research
Free to use with permission
REFERENCE

Key Results

Socio-demographics
52% were between the
age of 18 and 24 years
old
88% were single/never
married and/or
cohabitating
92% were on Medicaid
74% were enrolled in WIC
Maternal history
56% had 2 children (incl.
pregnancy)

How do you plan to feed your new baby (n=50)?

Breast (n=17); 34%

Both (n=19) ; 38%

Formula (n=14); 28%

Key Results

Median infant feeding

attitude score was 45
(range 19 to 72).

Plans for feeding new baby among currently unemployed mothers

(n=13)

No differences by # kids or
previous breastfeeding
history

Work
50% of women planned
to return to work
before/after 6 weeks
Nearly half of women
who were unemployed
planned to exclusively
formula feed

Both; 23%
Breast; 31%
Formula ; 46%

Conclusions
Attitudes toward breastfeeding do
not seem to be a clear indicator of
African American moms intentions
to breastfeed
Plans to breastfeed and use formula
was a common choice among our
sample

Implications for Practice &

Future Research
Despite low rates, African American
women are interested in
breastfeeding
Deeper understanding of what
influences infant feeding choices
(e.g., work?) among this population is
needed.

Questions???
Tisha Felder, PhD, MSW
Assistant Professor
College of Nursing &
Cancer Prevention and
Control Program, Arnold
School of Public Health
Phone: 803-777-9830
Email:
feldert@mailbox.sc.edu

Joynelle L. Rivers, EdD,

MSN, RNC
Clinical Assistant Professor
College of Nursing

Phone: 803-777-2806
Email:
jrivers@mailbox.sc.edu