379 - Interviews with WIC Clients to Inform a Breastfeeding Intervention

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 379
Publication Number: 379.102

Eve R.. Colson, University of Washington School of Medicine, Saint Louis, MO, United States; Emma Forbes, Boston University School of Medicine, Boston, MA, United States; Rachel Moon, University of Virginia School of Medicine, Charlottesville, VA, United States; Chanel Peguero, Boston University School of Medicine, Boston, MA, United States; Katherine E. Boguszewski, University of Virginia School of Medicine, Charlottesville, VA, United States; Fern R.. Hauck, University of Virginia School of Medicine, Charlottesville, VA, United States; Ann L. Kellams, UVA, Charlottesville, VA, United States; Marc T. Kiviniemi, University of Kentucky, Lexington, KY, United States

Presenting Author(s)

Eve R. Colson, MD, MHPE (she/her/hers)

Professor and Associate Dean
University of Washington School of Medicine
Saint Louis, Missouri, United States

Background:

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for 6 months and continuation of breastfeeding for up to two years or beyond. Low-income women who qualify for WIC have lower rates of any and exclusive breastfeeding, putting their infants at higher risk for SIDS, infections, and other illnesses.

Objective:

The objective of this study was to understand facilitators and barriers to breastfeeding through interviews with WIC clients to directly inform the content and delivery of an intervention to increase breastfeeding rates among women attending WIC.

Design/Methods:

Using qualitative methods, we conducted in-depth, semi-structured interviews with pregnant women and women with infants < 6 months old participating in WIC in Massachusetts and Virginia. Interviews focused on mothers’ experiences feeding their infants, facilitators and barriers to starting and continuing breastfeeding, as well as suggestions for how to leverage facilitators and overcome any barriers to inform the development of an intervention. Data collection and analysis followed an iterative process using constant comparison with multiple, diverse researchers with expertise in qualitative methods approach. Interviews were continued until thematic saturation was reached.

Results:

We interviewed 20 women and found factors influencing feeding choices included beliefs about logistics such as expense and time as well as the impact on health, and infant bonding. Initiation and continued breastfeeding were impacted (in both positive and negative directions) by issues related to returning to work, support from family and friends, competing priorities, ownership of the decision, and guidance from healthcare providers. Participants were influenced by a variety of sources including family, friends, healthcare providers including WIC staff and social media. They shared ideas for addressing barriers they and others faced and suggested strategies to help support breastfeeding.

Conclusion(s): Participants identified facilitators and potentially modifiable barriers to breastfeeding and offered strategies for improving interventions. This study is an exemplar of how to ensure that the participant voices, in this case WIC clients, are directly involved in the development of interventions to change health-related behaviors.