June 2010

Document Type


Degree Name



Oregon Health & Science University


Breastfeeding decreases the rate of disease in children, provides immunological benefits for the infant and benefits overall health by reducing the prevalence of overweight and obesity in children (1). In the United States, 74% of infants are “ever breastfed” (2). Initiation of breastfeeding varies between racial/ethnic groups with the highest initiation rate of 82.1% belonging to Hispanic women followed by 73.8% among Caucasian women (2). Since the 1970’s, Black women have had the lowest rates of breastfeeding in the United States (3). The current national breastfeeding initiation rate for Black women is 65% (2). In Oregon, over 90% of infants born are reported as “ever breastfed”(4). Among these infants, 63% are breastfed for six months or more (5). Black women in Oregon have a breastfeeding initiation rate of 83%; exceptionally higher than the national average (2). The primary objective of this project was to use a phenomenological approach to explore the unique breastfeeding experiences of Black women in Oregon who were enrolled in WIC, successfully initiated breastfeeding, and breastfed for a minimum of one month. The secondary aim was to determine elements for success that can be translated to increase breastfeeding rates of Black women outside of Oregon. A list of potential participants was extracted from the Oregon WIC client database. Fifty-two women met the eligibility criteria including non-Hispanic Black, English speaking, with a breastfed child under 1-year of age, and a duration of breastfeeding greater than one month. Thirty-seven women had accurate contact information and were invited to participate. Ten of these women completed a one-hour guided interview about their breastfeeding experiences. Interviews were transcribed verbatim and InVivo and Pattern coding were used to identify major themes. Three primary themes emerged from the data and were identified as influencing successful initiation of breastfeeding among Black women in Oregon. Primary themes identified included maternal self-efficacy, importance of the mother-child bond, and belief in the benefits of breastfeeding. Eight secondary aspects of the breastfeeding experiences within the study population were also explored. Participants who were recent immigrants from Africa expressed unique opinions about breastfeeding compared to the African-American women in the study. Four of the ten women were multiparous and had a decrease in breastfeeding duration with every additional pregnancy. Participants, independent of breastfeeding duration, believed that all mothers should attempt to breastfeed. The high rates of successful initiation of breastfeeding among the Black WIC mothers interviewed in this study may be attributed to both personal and environmental factors. Although most mothers experienced a number of barriers that could have led them to stop breastfeeding, their unwavering commitment to both motherhood and breastfeeding helped them continue. Encouragement to breastfeed from midwives, WIC, friends and family was appreciated but was not the deciding factor for initiating breastfeeding. Understanding the link between a woman’s perception of her role as a mother and her internal motivation to successfully breastfeed may be a critical component in designing interventions for women at high risk for not breastfeeding. In addition, since each woman’s motivation for breastfeeding was quite individual, tailored education rather than a one-size fits all approach has a greater potential for achieving success.




Graduate Programs in Human Nutrition


School of Medicine



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