Perceived Maternal Behavioral Control, Infant Behavior, and Milk Supply: A Qualitative Study
Elizabeth Peacock-Chambers1, Kaitlin Dicks, Leela Sarathy
1*Division of General Pediatrics, Boston Medical Center, Boston, MA; †Johns Hopkins Hospital, Baltimore, MD; ‡Department of Pediatrics, Brown University, Providence, RI; §Pediatrics and Adolescent Medicine, East Boston Neighborhood Health Center, Boston, MA.
Summary
Maternal decisions about breastfeeding exclusivity and duration are influenced by perceived control over milk supply and infant behavior. Understanding these evolving factors can help improve breastfeeding support for low-income mothers.
Area of Science:
- Public Health
- Maternal and Child Health
- Qualitative Research
Background:
- Breastfeeding exclusivity and duration disparities persist despite increased initiation rates.
- Maternal decision-making regarding infant feeding is complex and evolves over time.
- Diverse urban populations face unique challenges influencing infant feeding practices.
Purpose of the Study:
- To examine factors influencing maternal decisions on infant feeding practices over time.
- To understand the evolution of these decisions in a diverse inner-city population.
- To identify key themes impacting breastfeeding exclusivity and duration.
Main Methods:
- Prospective qualitative study involving 20 mothers from urban primary care clinics.
- Open-ended interviews and demographic questionnaires administered at 2 weeks and 6 months postpartum.
- Inductive and deductive thematic analysis of transcripts by 3 independent coders.
Main Results:
- All participants initiated breastfeeding; 65% reported perceived insufficient milk (PIM).
- Perceived insufficient milk (PIM) and behavioral control were key themes impacting early breastfeeding cessation.
- Maternal distress related to infant behavior and perceived control over milk supply evolved postpartum, influencing cessation decisions.
Conclusions:
- Infant feeding decisions are dynamic, influenced by perceived control over milk supply and infant behavior.
- Tailored, time-sensitive anticipatory guidance is crucial for supporting maternal agency in breastfeeding.
- Interventions should address psychosocial demands and promote coping strategies for challenging infant behaviors.
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