PC2022: Barriers and Facilitators to Exclusive Breastfeeding in Cincinnati Latina Mothers

Background: Although breastfeeding rates are increasing in the United States, there are significant cultural disparities in breastfeeding duration and exclusivity. Nationally, Hispanic infants are much less likely to be exclusively breastfed at 6 months than non-Hispanic white infants. In our own community, available data demonstrates that Latina mothers initiate breastfeeding at or above rates of the general population, but exclusive breastfeeding rates are disproportionately low. Our objectives were to explore reasons for supplementation and non-exclusive breastfeeding in the Latinx population, and to evaluate facilitators and barriers to exclusive breastfeeding and the promotion of longer breastfeeding duration after hospital discharge.

Methods: We recruited self-identified Latinx (Hispanic or Latina) mothers >=18 years old identified through community partners to complete a survey designed to explore breastfeeding knowledge, past and present infant feeding practices, and attitudes toward formula use.
Demographic data including age, number of children, family structure, WIC status, employment status, educational level, zip code, and previous breastfeeding experience was collected.

Results: Forty-nine participants completed the survey, and 96% reported that they had breastfed, though most (82%) did not do so exclusively. Fifty-one percent reported early supplementation in the hospital. The average age was 28.9 years (SD 6.43, 19-47) with 3.4 pregnancies (0-8, SD 1.87). Eighty-five percent delivered vaginally. Seventy-nine percent received WIC, 81% were unemployed, 42% were single. Fifty-seven percent reported their highest level of education was grade school. Seventy-seven percent were born in Guatemala, 12% in Mexico, 4% Puerto Rico, 4%US, and 2% Honduras. Most women agreed that breastfeeding was the healthier feeding choice, and breastfeeding was more convenient and less expensive than formula feeding. Sixty-nine percent reported receiving prenatal breastfeeding education, and 91% felt that the education influenced their feeding decision. Though 81% agreed that most mothers have enough milk to feed their babies, the most common reason for breastfeeding discontinuation was that the infant was still hungry/not enough milk. Forty-six percent reported supplementing with formula because they felt they didn’t have enough milk, and 62% believed it was hard to tell when the baby was getting enough milk.

Conclusion: Though breastfeeding was common in our study population and most reported positive attitudes toward breastfeeding, supplementation with formula occurred frequently and early. Most mothers in our cohort received education about breastfeeding during their pregnancy and were influenced by the information. Our results underscore an opportunity to tailor this education to address the common concern for insufficient milk supply and to highlight the importance and benefits of exclusive breastfeeding. Next steps include qualitative analysis of semi-structured interviews to better characterize knowledge gaps specific to this community.