Low-income mothers discuss the barriers and benefits of breastfeeding

Introduction:  The American Academy of Pediatrics recommends exclusive breastfeeding for six months of an infant’s life; however, most U.S. women find this difficult, given a complex interplay of personal and structural barriers.

Methods: Ninety low-income mothers (African-American and White) from three counties in North Carolina participated in in-depth qualitative interviews about feeding practices and the food environment, including experiences with breast and formula feeding. 

Results: Sixty mothers (67%) had ever breastfed, with ten breastfeeding in the hospital only. Fifteen mothers (16.7%) were still breastfeeding at six months, and six (6.7%) at twelve months.  Only twelve mothers (13.3%) exclusively breastfed for six months.  Mothers who tried to breastfeed but did not continue reported a lack of support related to breastfeeding. They recounted negative experiences like pain and discomfort, privacy concerns, and perceptions of low-milk production that led them to discontinue. Mothers who reported positive experiences with breastfeeding said they enjoyed “bonding” with their children, losing weight easily, and the health benefits of breastfeeding.

Discussion: Rates of ever breastfeeding and exclusive breastfeeding for six months among study participants were lower than rates in the population at large, according to the CDC National Immunization Survey.   Breastfeeding challenges may be greater for low-income women.  For several mothers we talked to, going back to work at low-wage shift jobs led to a rapid decline in milk production and impeded their ability to breastfeed or pump. Understanding how low-income women experience breastfeeding is key to developing policies that will effectively support women who wish to breastfeed.