Understanding breastfeeding initiation and continuation in rural communities: a combined qualitative/quantitative approach.

Journal Article (Journal Article)

OBJECTIVE: To determine factors associated with breastfeeding in rural communities. METHODS: We combined qualitative and quantitative data from the Family Life Project, consisting of: (1) a longitudinal cohort study (N=1292) of infants born September 2003-2004 and (2) a parallel ethnographic study (N=30 families). Demographic characteristics, maternal and infant health factors, and health services were used to predict breastfeeding initiation and discontinuation using logistic and Cox regression models, respectively. Ethnographic interviews identified additional reasons for not initiating or continuing breastfeeding. RESULTS: Fifty-five percent of women initiated breastfeeding and 18% continued for at least 6 months. Maternal employment at 2 months and receiving WIC were associated with decreased breastfeeding initiation and continuation. Ethnographic data suggested that many women had never even considered breastfeeding and often discontinued breastfeeding due to discomfort, embarrassment, and lack of assistance. CONCLUSIONS: Breastfeeding rates in these rural communities lag behind national averages. Opportunities for increasing breastfeeding in rural communities include enhancing workplace support, maximizing the role of WIC, increasing hospital breastfeeding assistance, and creating a social environment in which breastfeeding is normative.

Full Text

Duke Authors

Cited Authors

  • Flower, KB; Willoughby, M; Cadigan, RJ; Perrin, EM; Randolph, G; Family Life Project Investigative Team,

Published Date

  • May 2008

Published In

Volume / Issue

  • 12 / 3

Start / End Page

  • 402 - 414

PubMed ID

  • 17636458

Pubmed Central ID

  • PMC2692345

International Standard Serial Number (ISSN)

  • 1092-7875

Digital Object Identifier (DOI)

  • 10.1007/s10995-007-0248-6


  • eng

Conference Location

  • United States