I have followed with interest the discussion of breastfeeding among
African-American moms.  I think in any health decision any person makes,
culture, values, and beliefs play a huge role.  We often feel as healthcare
providers that if we just give the right scientific info to folks, they will
naturally make the decision we want them too (which is of course, the
"right" decision.)
When I was a resident, I did a survey of moms receiving WIC as part of my
community medicine rotation.  It was a small sample (about 80 moms) and all
but 2 or 3 were African-American.  I was interested in seeing both what the
breastfeeding rates were, and what might influence moms to initiate and
continue.  The initiation and continuation rates were pretty dismal.
Interestingly, encouragement by a healthcare provider did not seem to make
much difference, unless the mom also had some support from their own mom,
grandma, or other family member.  Those who did not list such support had
very low rates of initiation even if they reported a healthcare person
encouraged them.
I also asked moms to list benefits of breastfeeding (this was before I heard
of weissingerizing my language!)  Almost all moms could spontaneously list a
benefit, such as improving health, less ear infections, etc.  It seemed to
me that at least in the few women who answered my survey, *knowledge* was
not nearly as much of a problem as *support*
Mary Kay Smith who worked on this with me some and I pondered how to get the
word out to grandmas and great-grandmas.  We thought maybe a campaign in the
beauty parlors?  Churches?
This study was very simplistic and I have to admit after I tried to analyze
the data that I wished I had worded it much differently.  However, before I
conducted the survey I thought if I could just convince moms of the
scientific facts, I could convince them to breastfeed.  After, I tried much
harder to explore what beliefs and values might lead to their decisions.  Of
course, I can't usually change those, and I can't always even find a way to
understand them enough to be of some help, but I've had much better luck if
I don't ignore that their might be something other than the "facts"
influencing a decision.
(Then of course, I could go on for pages about whether there is even such a
thing as some kind of value-neutral scientific fact, but that's another
discussion.)
Jennifer Tieman
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html