Author and graduation date: Norma Jean EICHE, November, 2000

Committee members: Donna Beshgetoor (Chair), Kathryn LaMaster, Judy M. Price

Thesis title: Assessment of Attitudes Toward Breast-feeding Among WIC Participants

Breast-feeding is known to promote optimal nutrition for infants during early postnatal life. Although the promotion of breast-feeding is an integral part of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), breast-feeding initiation rates for women enrolled in WIC fall far below national averages. Thus, the objective of this study was to utilize a pretested instrument to determine factors that tray favor or disfavor breast-feeding practices among WIC mothers. WIC participants from five agencies in San Diego County, California, were recruited to complete an attitudinal survey on breast-feeding. Completion of the survey was voluntary and all data were anonymously obtained. Chi-square analysis was used to determine factors affecting mothers' infant feeding decisions. Statistical significance was defined as p < 0.05.

A total of 128 pregnant women volunteered to participate in the study. A majority of the participants were 18 to 30 years of age, Hispanic or Caucasian, high school educated, single, primiparous, and unemployed. A majority of mothers (88.7%) expressed an intention to breast-feed. Of those intending to breast-feed, most reported plans to breast-feed for either 5 to 8 months or 9 to 12 months. Many of these mothers also intended to supplement breast-feeding with formula-feeding. Among mothers who reported their intention to formula-feed, most planned to formula-feed their infant for 9 to 12 months. However, a small portion of mothers reported intentions to exclusively breast-feed (12.8%) or exclusively formula-feed their infants (11.3%).

Results indicated that intentions to breast-feed or formula-feed were not significantly related to age, ethnicity, education, marital status, or parity. Maternal employment was the only sociodemographic variable related to a mother's infant feeding decision, although its correlation to breast-feeding intentions was weak. In contrast, many attitudinal variables were significantly related to a mother's intention to breast-feed her infant. A mother's determination to breast-feed and her belief that she was physically able to breast-feed were strongly correlated with her breast-feeding intention. Additionally, a mother's intention to breast-feed positively correlated with beliefs that breast-feeding is healthier, more natural, more nutritious, the best way to feed an infant, the perfect food for infants, and is a means for her to feel closer to her infant. Breast feeding intentions did not significantly correlate with statements that breast-feeding is less expensive or is easier to digest than infant formula. Finally, the statement, "I am determined to breast-feed my baby." was the only statement negatively correlated to a mother's intention to formula-feed.

In summary, this study demonstrated that positive attitudes toward breast-feeding were associated with a mother's intention to breast-feed. Thus, breast-feeding promotion programs need to develop means of enhancing a mother's positive attitudes toward breast-feeding. In addition, improved intervention strategies that promote breast-feeding tray give a mother more confidence to exclusively breast-feed her infant, considering that a high percentage of mothers in this study planned to supplement breast-feeding with infant formula.

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