Against the odds: breastfeeding experiences of low income mothers.

This qualitative study asked low income mothers about their experiences of breastfeeding care in the health system and about integrating breastfeeding into their daily lives. Focus group interviews were conducted with urban and rural nursing mothers who participated in the WIC Program and were supported by breastfeeding peer counselors. Mothers said that helpful breastfeeding care providers knew correct information, established supportive personal relationships, referred women to breastfeeding specialists for problems, showed enthusiasm for nursing, and facilitated breastfeeding through concrete actions during the prenatal, intrapartum, and postpartum periods. Unhelpful providers missed opportunities to discuss breastfeeding, gave misinformation, encouraged formula supplementation, provided perfunctory or routine breastfeeding care, and were hard to contact when problems arose. Women valued their breastfeeding peer counselors for responding promptly to distress calls, making home visits, being knowledgeable about breastfeeding, providing hands-on assistance, and acting personal and caring. Incorporating breastfeeding into daily activities was a challenge for many mothers. Ambivalence about the physical bond of nursing, personal modesty, and getting on with life at home, work, or school were identified as important issues. Listening to the thoughts and experiences of low income nursing mothers can help health workers to provide more culturally sensitive, effective breastfeeding care to this population.