(P02-020-25) Beyond Breastfeeding Initiation: Formative Research to Support Exclusive Breastfeeding at Birthing Hospitals Among Latina Women Living in a Rural U.S.-Mexico Border County

Objectives: Most infants in the U.S. initiate breastfeeding. However, by two days of age, 19% of all infants and 33% of Latine infants in the U.S. consume infant formula. This study examines the facilitators and barriers to exclusive breastfeeding at birthing hospitals among Latina women living in a rural county on the U.S.-Mexico border.

Methods: In-depth interviews were conducted with < 2 months postpartum Latina women (n=28) and healthcare (n=5) and nutrition (n=7) service providers. The Social Ecological Model provided a theoretical grounding for developing the interview guides, analysis, and interpretation of findings. Thematic analysis to identify and organize themes through deductive and inductive coding was completed using Dedoose.

Results: All postpartum participants identified as Hispanic or Latina women (n=28). Spanish was the primary language for most (n=20), and a quarter grew up in Mexico (n=7). Nearly all intended to provide at least some human milk to their infant (n=27), and four intended to exclusively breastfeed. Most successfully initiated breastfeeding within 24 hours of delivery (n=23). Hospital staff prioritized the uninterrupted skin-to-skin contact between the newborn and birthing parent in the first hour, known as the “golden hour.” Postpartum women identified immediate skin-to-skin contact as the main facilitator of breastfeeding initiation within the first 24 hours of delivery. Most women received some breastfeeding counseling or support at the birthing hospital (n=24), but also either asked for or were offered formula by hospital staff (n=20), and nearly two-thirds (n=18) fed their newborns formula at the hospital. Perceived insufficient milk, coupled with the tendency of hospital staff to suggest or provide formula, were barriers to exclusive breastfeeding at the birthing hospitals.

Conclusions: Parental concerns about insufficient milk coupled with the readily available provision of infant formula in the hospital likely contributed to in-hospital formula use. Hospital-based interventions to support early breastfeeding initiation and exclusivity should include timely support and counseling during the “golden hour” after delivery and throughout the hospital stay, especially to address perceived insufficient milk.

Funding Sources: Vitamin Angel Alliance, Inc.