Initiating and sustaining breastfeeding in african american women.

OBJECTIVE To explore issues related to initiating and sustaining breastfeeding in African American women. DESIGN Qualitative design using focus groups, guided by Leininger's theory of culture care diversity and universality. SETTING Three different regions of a southeastern state in the United States. PARTICIPANTS Fifteen self-identified African American women who had recently breastfed were recruited by lactation consultants and by word of mouth. METHODS Three focus groups were conducted with initial guiding questions. New ideas that emerged were fully explored in the group and included as a guiding question for the next group. RESULTS Categories identified from the data were reasons to start and stop breastfeeding, advice about breastfeeding that was useful or not useful, and cultural issues related to breastfeeding that were perceived to be unique among African Americans. Three overall themes were identified that cut across categories: perceived lack of information about benefits and management of breastfeeding, difficulties breastfeeding in public, and lack of a support system for continued breastfeeding. CONCLUSION Women need to be taught early in their pregnancies about the benefits of breastfeeding and offered continuing support and teaching once breastfeeding is established. Peer support groups for breastfeeding African American women should be established.