(P20-012-24) Characterizing Breastfeeding Intentions Among Latina Women in a Rural County on the United States-Mexico Border

Objectives: Breastfeeding intention is associated with breastfeeding initiation and exclusivity. This study, grounded in the Theory of Planned Behavior, aimed to characterize breastfeeding intentions and their behavioral antecedents (attitudes, subjective norms, and perceived behavioral control) among Latina women in a rural U.S.-Mexico border county.

Methods: Breastfeeding intentions were characterized through semi-structured, in-depth interviews with 3^rd trimester pregnant (n=8) and < 2 months postpartum (n=28) Latina women and healthcare (n=5) and nutrition service providers (n=7) in a rural U.S.-Mexico border county in Arizona. Thematic analysis of transcripts was completed to identify and organize themes via deductive and inductive coding using Dedoose.

Results: All pregnant and postpartum participants identified as Hispanic or Latina women. Most spoke Spanish at home (n=28), one-third were primiparous (n=13), most graduated high school (n=24), and most were enrolled in WIC (n=27). Women expressed their intentions to breastfeed during the prenatal period in one of four ways: exclusive breastfeeding (n=4), breastfeeding (not specifying any or exclusive) (n=22), partial breastfeeding (n=8), or formula-only (n=1). Those who intended to breastfeed or exclusively breastfeed had positive breastfeeding attitudes (breastfeeding improves infant nutrition or enhances bonding). Subjective norms for breastfeeding, namely family influences, were more influential on intent than attitudes. Women who intended to breastfeed or partially breastfeed typically described partial breastfeeding as the norm in their families. Perceived behavioral control, primarily related to returning to work, was the strongest influence on whether and when women intended to feed their infants formula, especially among women who intended to partially breastfeed or formula-feed only. Perceptions of women and service providers were concordant regarding family influences and challenges of returning to work but were discordant regarding the confidence women have to pump at work.

Conclusions: Breastfeeding intention is a strong, modifiable determinant of practice. Strengthening intent to exclusively breastfeed for six months while addressing the barriers to doing so provides an opportunity for intervention during pregnancy.

Funding Sources: Vitamin Angel Alliance, Inc.