Associations Between Breastfeeding and Parenting Among Young, Low-Income, African American Mothers

Background and Purpose:  Evidence suggests that breastfeeding provides infants, mothers, families, and society with numerous health, developmental, psychological, and economic benefits.  It has often been claimed that mothers who breastfeed show greater warmth while interacting with their infants and are more attuned to their infants' cues.  Yet there are few empirical data examining the correlations between breastfeeding and maternal feelings and behavior among racial minority, low income, or adolescent mothers, even though these mothers are often the recipients of perinatal support services that include a breastfeeding component.  Therefore, the purpose of this study was to examine the association between breastfeeding initiation and parenting efficacy and behavior in a sample of young, low income mothers.     

Methods:  Young, African American mothers (n=248) were recruited from the prenatal clinics of an urban teaching hospital to participate in a study of a doula home visiting intervention.  Mothers were administered interviews during pregnancy, at the birth, and at 4 months postpartum.  Mothers ranged in age from 14 to 21 years (M=18.3, SD=1.7) at the birth, and 94% were receiving Medicaid.  At 4 months postpartum, mothers (n=221) completed  the Maternal Self-Efficacy Scale, a well-validated, 10-item measure of maternal self-efficacy related to infant care.   Mothers were also videotaped interacting with their 4 month old infants.  Observers masked to mother information coded videos for maternal sensitivity and positive and negative regard for the infant using global rating scales developed for the NICHD Study of Early Child Care.  Inter-rater reliability exceeded .9 for each dimension of parenting behavior.

Results:  56% (n=139) of the mothers initiated breastfeeding, with a mean duration of 7.1 weeks (SD=10.9) among those who initiated.  7% (n=15) of mothers were still breastfeeding at 4 months postpartum.  After controlling for a variety of covariates, including maternal age, vocabulary score, depression, prenatal self efficacy, and current breastfeeding, regression analyses showed that breastfeeding initiation was associated with greater maternal self-efficacy at 4 months postpartum (t=2.90, p<.01).  Mothers who initiated breastfeeding also showed more positive regard (t=2.61, p<.01) and were observed to be more sensitive towards their infants (t=1.98, p<.05) than mothers who never breastfed.

Conclusions and Implications:  Past research has shown that low income, adolescent mothers are much less likely to initiate breastfeeding than older, more socially advantaged mothers, though the benefits associated with breastfeeding may be most important for young mothers and their infants.  Although causal claims cannot be made, the results of this study showed that breastfeeding was related to greater feelings of parenting efficacy and positive parenting behaviors several months after the birth among the young mothers in this sample.  Social workers are often part of the perinatal team that provides support services to vulnerable mothers, and these findings suggest that breastfeeding support and education may serve as an important avenue for enhancing parenting outcomes and the parent-infant relationship.