Graduation Year

2014

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Nursing

Major Professor

Maureen Groer, Ph.D.

Committee Member

Cecilia Jevitt, CNM, Ph.D.

Committee Member

Jason Beckstead, Ph.D.

Committee Member

David Himmelgreen, Ph.D.

Keywords

Culture, Exclusive Breastfeeding, Infancy, Lactation, Latino, Postpartum

Abstract

Breastfeeding confers immunological, physiological and psychological benefits for the infant and mother as well as social and economic benefits to the nation. The United States Department of Health and Human Servcies (HHS), Healthy People 2020 has established national objectives for the initiation and duration of breastfeeding at 82% initiation, 61% at six months and 34% at one year. In addition, they have set goals for exclusive breastfeeding at 3 months to be 46% and 25% at 6 months of infant's age. Currently breastfeeding initiation is at the highest recorded level of 76.9%, yet significant disparities exist (CDC, 2012). The purpose of this study was to examine the association of acculturation and self-efficacy on breastfeeding behavior of a sample of Hispanic women. Initially the plan was to focus on women from Mexican, Cuban and Puerto Rican countries of origin. However recruitiment goals for only the Mexican population were reached. Two valid and reliable bidimensional instruments were used in addition to collecting contextual information to foster a more comprehensive understanding of the acculturation process. The roles of self-efficacy and social support and their relationship with acculturation measures and breastfeeding behavior was explored. The Non-Hispanic domain subscale of the Bidimensional Acculturation Scale scores were significantly different for those breastfeeding compared to those formula feeding, indicating higher levels of Non-Hispanic domain acculturation associated with not breastfeeding. Acculturation and self efficacy (general and parental) were not found to be related. Breastfeeding outcomes and parental self-efficacy were found to have a significant negative correlation, a finding that was in an unexpected direction, with higher parental self-efficacy associated with decreased breastfeeding intensity. Mixed feeding or Las Dos, is a common finding among Hispanic women especially for the Mexican origin community and exclusivity may not have been perceived as higher value then mixed feeding or formula feeding (Bunik et al., 2006). Rates for exclusive breastfeeding at three months are 33% for both the US as well as for Hispanic/Latino ethnicity (National Immunization Survey, 2007). At six weeks the practice of exclusively breastfeeding (not giving formula) was 17% and this is about half of the 46% goal set for exclusive breastfeeding at three months by (HHS) Healthy People 2020. Of those that were exclusively breastfeeding in the hospital only three were still exclusively breastfeeding at the six week follow up call. This presents a unique opportunity in which targeting Hispanic mothers after discharge may assist in increasing further the rates of exclusive breastfeeding and recommendations are provided.

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