Exploration of reasons for feeding choices in Hispanic mothers.

PURPOSE: To explore factors that contribute to feeding choices Hispanic women make for their newborn infants in the immediate postpartum period, with a focus on the phenomenon of "los dos," breastfeeding with formula supplementation. STUDY DESIGN AND METHODS: A descriptive qualitative design that utilized a semistructured interview guide with open-ended questions was used. Qualitative data preparation and analysis methods were used to identify themes surrounding feeding choices. The sample included 19 women within 48 hours of giving birth who self-identified as Spanish speakers.
RESULTS: Reasons included 1) previous experience; 2) "no llora con hambre" (no crying for hunger); 3) "para salud" (for health); and 4) to prevent suffering that might occur when the mother and infant were separated while the mother worked "no quiero que sufra mientras trabajo." CLINICAL IMPLICATIONS: Discussion of infant feeding choices should occur prior to birth since many mothers decide on feeding method while still pregnant. At the first prenatal visit identification of preference should occur to include not just breast or formula, but also asking about "los dos." Educational interventions that directly address the "los dos" feeding practice should be culturally appropriate, evaluated and disseminated for use in the prenatal period. Influential family members should be included in prenatal visits and educational sessions to help assure that the woman is not receiving mixed messages at home. Assessment of the workplace environment should also occur during the prenatal period with an exploration of how pumping and storing of breast milk might be possible once women return to work after the baby's birth.