Exploring the Barriers to Exclusive Breastfeeding in Bucks, Montgomery and Philadelphia Counties: Promoting Mother-to-Mother Support

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Capstone Committee:

Tara Bernabe, President of the Nursing Mother's Advisory Council (NMAC)

Dr. Rickie Brawer, Thomas Jefferson University

Dr. James Plumb, Thomas Jefferson University

Dr. Albert Crawford, Thomas Jefferson University


The health benefits of breastfeeding for mother and child have been well- documented in scientific research. The American Association of Pediatricians (AAP) recommends exclusive[1] breastfeeding for the first six months of life. The WHO (2008) has endorsed that standard and encouraged continuing with supplements of age- appropriate foods for up to two years. The purpose of this study was to examine the facilitators and barriers to breastfeeding experienced by women in Philadelphia, Bucks, and Montgomery counties who successfully breastfed to six months. These positive deviants represent a small portion of the population who met the goal and have the ability to make informed recommendations for future mothers. A retrospective, descriptive design using qualitative methods was used for this study. 4 focus groups were conducted and a total of 23 women participated. Primary data content analysis revealed 5 major themes related to breastfeeding to 6 months: Decisionmaking, Breastfeeding Initiation, Breastfeeding Continuation, Returning to Work/School, and Recommendations. Facilitators included (1) self- motivation (e.g. mean prenatal breastfeeding self- efficacy rating 8.6), (2) family support, and (3) lactation consultant support/follow-up. Barriers to continuation included (1) physical barriers, (2) family discouragement, and (3) lack of respect for mother’s wishes in the hospital. Though the recommendation stems from the AAP, physician advice was least often mentioned as the impetus to initiate/continue breastfeeding. Rather, personal connections with family members, spousal support, and lactation consultant interaction were the preferred sources of encouragement for women from initiation to cessation. Breastfeeding support groups were also found helpful. Affordable lactation consultant follow- up and increased maternity leave were recommended.

Presentation: 31 minutes

[1] The World Health Organization (WHO) defines exclusive breastfeeding as giving the infant no liquid or solids other than breastmilk.