Breast milk is the preferred source of nutrition for most infants, and is associated with well-documented health benefits for both mother and child. Additionally, increased frequency of breastfeeding could annually save the United States billions of dollars and hundreds of lives. Despite this, the US consistently falls short of breastfeeding goals. For example, only 49% of of recent mothers breastfed for at least six months as recommended, compared with the goal of 61%. Breastfeeding decisions are often influenced by various cognitive and social factors.
[Photo: Dr. Patricia Markham Risica]
This study, conducted by Dr. Patricia Markham Risica, associate professor of epidemiology and behavioral and social sciences, sought to examine the changes in breastfeeding-related knowledge, attitudes, and self-efficacy, and prenatal breastfeeding intentions among low-income smoke-exposed women during the course of pregnancy. Furthermore, the study also examined how changes in knowledge, barriers, and self-efficacy may influence feeding behaviors among women who had not yet decided on feeding plans early in their pregnancies.
Researchers interviewed 399 low-income, adult women during the 16th and 32nd week of their pregnancies to investigate their prenatal feeding intentions and breastfeeding knowledge, attitudes, and self-efficacy. They then measured infant feeding initiation at delivery and 30 days postpartum, and were asked to describe their current breastfeeding practices. Differences in psychosocial variables between women of intention for infant feeding were measured.
It was found that infant feeding decisions for many women evolve throughout pregnancy. Feeding intention early in pregnancy was strongly, but not consistently, associated with feeding intention late in pregnancy, feeding initiation, and later feeding patterns. Over one-third of women who were undecided at 16 weeks gestation or earlier initiated breastfeeding. Increases in knowledge and improvement in time, social factors, and social support barriers were found among those who exclusively breastfed.
Ultimately, the current study revealed that a small, but important, proportion of women decide how they will feed their infant during pregnancy, some even very soon before delivery. It was documented that breastfeeding plans are prone to change during pregnancy even among those with seemingly firm plans. These findings highlight opportunities for breastfeeding support, education, and motivation of low-income women throughout pregnancy.
This study was published in August in Public Health Nutrition, Volume 20.