One Step for a Hospital, Ten Steps for Women: African American Women’s Experiences in a Newly Accredited Baby-Friendly Hospital

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Background:Despite strides made by the Baby-Friendly Hospital Initiative to improve and normalize breastfeeding, considerable racial inequality persists in breastfeeding rates. Few studies have explored African American women’s experience in a Baby-Friendly Hospital Initiative system to understand sources of this inequality.Research aim:This study aimed to explore African American women’s experiences of the Ten Steps to Successful Breastfeeding at a women’s center associated with a university-affiliated hospital that recently achieved Baby-Friendly status.Methods:Twenty African American women who had received perinatal care at the women’s center and the hospital participated in qualitative interviews about their experiences. Data were organized using the framework method, a type of qualitative thematic analysis, and interpreted to find how African American women related to policies laid out by the Ten Steps to Successful Breastfeeding.Results:Three key themes emerged from the women’s interviews: (a) An appreciation of long-term relationships with medical professionals is evident at the women’s center; (b) considerable lactation problems exist postpartum, including lack of help from Baby-Friendly Hospital Initiative sources; and (c) mothers’ beliefs about infant autonomy may be at odds with the Ten Steps to Successful Breastfeeding.Conclusion:Hospitals with Baby-Friendly status should consider models of breastfeeding support that favor long-term healthcare relationships across the perinatal period and develop culturally sensitive approaches that support breastfeeding beliefs and behaviors found in the African American community.

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