How do knowledge and attitudes relate to the initiation of breastfeeding in Native American women in a North Dakota health care facility?

Abstract

Despite research consistently demonstrating the benefits of breastfeeding, Native American women in North Central North Dakota have the lowest rate of breastfeeding in North Dakota with a rate of 8.24%. The reasons why these women are not breastfeeding are not known. There have been no studies regarding the attitudes and knowledge about breastfeeding of these women or their health care professionals. The purpose of this study was to assess the knowledge and attitudes about breastfeeding in this population. Thirteen pregnant women, ten women who have given birth, and twelve health care professionals who provide care to these women comprised the sample of this descriptive study. The results of the surveys demonstrated that these women knew the benefits of breastfeeding but the majority of them did not breastfeed their infants. Attitudes seem to be a more relevant factor than knowledge in influencing breastfeeding initiation in this sample of women. Health care providers should be aware that their own attitude toward breastfeeding may affect a woman's choice to breastfeed. Results also demonstrated the health care professionals had limited education about infant feeding, lactation, and breastfeeding. These health care providers may be providing conflicting and possibly incorrect knowledge about breastfeeding. Current evidence based breastfeeding recommendations and practices should be incorporated into continuing education so consistent and correct information is provided. Health systems should establish a baby friendly environment that supports and encourages breastfeeding. In addition, the unique characteristics of the Native American women in North Central North Dakota, or any community in which one lives or works, should be considered to better plan interventions that will be effective and sustainable. It is not one identifiable factor that the decision to breastfeed is dependent upon, but factors that may interact and overlap in ways to influence a women's decision to breastfeed. Understanding context is vital to designing and implementing successful interventions in breastfeeding promotion. Culturally relevant information gathered from this population may not be transferable to others in this particular tribe who may live somewhere else or to other Native American tribes, as their specific cultural attributes may be different from this particular tribe.