OBJECTIVE: To examine cultural and socioenvironmental factors that affect breastfeeding initiation among African American women.DESIGN: Qualitative descriptive design and conventional content analysis.SETTING: A large, inner-city, primary care center affiliated with a 500-bed children's hospital within a large, Northeastern U.S. city.PARTICIPANTS: Participants were 34 U.S.-born African American mothers of healthy term infants 0 to 3 months of age.METHODS: Six focus groups were conducted using a 16-question, scripted interview guide.RESULTS: A number of complex factors that influenced breastfeeding initiation included certain cultural beliefs about sexuality, the influence of family and peer networks, information sources, intentions, and a variety of other barriers and facilitators.CONCLUSION: Our findings suggest that the decision to initiate breastfeeding is not solely determined by the woman within the African American community. Because this decision is contingent on multiple factors external to the woman, it is important to recognize the role that partners, grandmothers, communities, information sources, and health care providers/organizations play in women's decisions. Implementation of multilevel strategies is critical to increase breastfeeding initiation among African American mothers.
Adult African Americans