(P18-033-23) Feelings of Pressure To Breastfeed and Shame Over Formula Use in New Mothers Highlight the Need To Destigmatize Messaging to New Mothers

Objectives: Supply chain issues that began in 2020 and a major infant formula recall in 2022 resulted in the depletion of infant formula supply triggering a nationwide crisis. This study aimed to describe new mothers' thoughts and emotions toward breastfeeding and infant formula use and explored potential supports to improve maternal well-being postpartum.

Methods: Inductive thematic analysis was conducted on ten 60-minute semi-structured interviews (03/20-11/20) with primiparous mothers in their third trimester or with a child ≤12 months who shared their experiences with health, diet, breastfeeding, and body image while becoming mothers.

Results: Eighteen themes emerged, including emotional experiences of breastfeeding, which revealed competing desires and emotions surrounding lactation and infant formula use. Participants cited the reasons compelling them to breastfeed: baby's nutrition, antibodies-particularly during COVID-19, and maternal-child bonding. Mothers indicated a strong desire to breastfeed their newborns, most of them for at least one year. However, three participants described external "pressures to breastfeed" from society, "the culture of breastfeeding" and remember hearing "the whole breast is best and all that" in the hospital. Concurrent with the desire to breastfeed, most (8/10) participants expressed feeling guilt, "like a failure," "doing myself an injustice," or "extremely disappointed and dissatisfied and upset" at the prospect of not being able to breastfeed. Only one participant expressed a neutral opinion towards using formula compared to breastmilk: "I'm willing to do whatever is necessary for my baby...if that means that it's just formula, I'll do whatever I need to."

Conclusions: This analysis provides an understanding of new mothers' goals and emotions surrounding breastfeeding. Reducing perceived pressures to breastfeed is an opportunity to improve maternal well-being postpartum. Unfortunately, an unintended consequence of public health messaging to promote breastfeeding is increased feelings of "failure" as a mother if one has to use infant formula. Finding ways to promote breastfeeding while destigmatizing infant formula use is imperative, particularly in light of the recent formula shortage.

Funding Sources: Saint Louis University, Applied Health Research Grant Program