(P18-047-23) Latina Women’s Experiences With Breastfeeding Care and Recommendations for Quality Improvement: A Qualitative Study

Objectives: Providing high-quality, person-centered breastfeeding care for women of color is critical for addressing breastfeeding inequities. Our objectives were to understand breastfeeding care experiences among Latina women during prenatal, birth, and postpartum visits and to describe their recommendations for improvement.

Methods: In-depth interviews were conducted with 21 Latina women with low incomes in Connecticut and data were analyzed thematically. The study was guided by the WHO quality of care framework for maternal and newborn health, which specifies three positive care experience domains: effective communication, respect and dignity, and emotional support.
Results: During prenatal visits, women received little or no breastfeeding information and felt rushed due to the short length of visits. Postpartum visits often did not cover breastfeeding in-depth, if at all. Women reported a lack of racial/ethnic and language concordance between themselves and healthcare team members, which hindered communication. While some women felt respected by their healthcare team, others reported instances of disrespect – for example, when they felt pressured to formula feed against their wishes to breastfeed, or when healthcare team members were “rude” or “rough” when providing lactation management support. Lactation consultants offered emotional support and encouragement after delivery but were often unavailable. When providers did not offer postpartum breastfeeding support and encouragement, women felt discouraged. To promote positive breastfeeding care experiences, women recommended: the integration of breastfeeding peer counselors and doulas into care teams; more providers who are Latina and/or speak Spanish; increased access to timely support; and healthcare teams that respect women’s decisions to breastfeed and provide respectful care.

Conclusions: Latina women reported diverse breastfeeding care experiences and made specific recommendations for improving care. These findings can inform the co-design of breastfeeding care quality improvement interventions seeking to provide equitable breastfeeding care.

Funding Sources: Rhodes was supported by NHLBI (K12HL138037). This work was also supported by Cooperative Agreement Number 5 U48DP006380-02-00 funded by the CDC Prevention Research Center Program (PI: Pérez-Escamilla).