Exploring Higher Rates of Breastfeeding Among Civilan Military Wives: A Mixed Methods Study

Abstract

Background: As compared to the U.S. general postpartum population, civilian military wives (CMWs) encounter unique challenges that can impede their ability to breastfeed, including geographic replacement and physical and emotional challenges. Yet despite these challenges, CMWs demonstrate higher rates of breastfeeding initiation and duration in the U.S. postpartum population as a whole. Purpose: The purpose of this study was to explore factors contributing to the high rate of breastfeeding initiation and duration among CMWs and to determine what might be learned from these factors for intervention design for the broader population of postpartum mothers. Sample/Setting: The sample consisted of 28 CMWs whose ages ranged from 18-45. Methods: Concurrent mixed-methods design. Results: Seven main themes with 16 subthemes emerged from the descriptions of the semi-structured interviews and the BSE score of the CMWs was 55.2(SD = 5.73). The results of the integrative analysis revealed that factors within the military environment influence a sense of community, thus supporting their BSE. Additionally, supportive and pro-breastfeeding healthcare facilitators (especially lactation consultants) throughout the prenatal, intrapartum, and postpartum periods described by CMWs were associated with high levels of BSE among CMWs. Moreover, high levels of BSE related to breastfeeding skills and duration were associated with the accessibility of resources within the military environment, breastfeeding health and economic benefits, and setting of a breastfeeding goal. Conclusions: Using a concurrent mixed-methods design, this study identified facilitators from the descriptions of CMWs that they believed promote their higher rates of breastfeeding initiation and continuation, quantified their high level of breastfeeding self-efficacy, and identified descriptive factors that contributed to both areas lacking in the literature among this population. In the future, the integration of the prominent themes (and subthemes) into interventions that target lower BSE in other populations has the potential to improve breastfeeding initiation and duration among those populations. Keywords: breastfeeding, civilian military wives, concurrent mixed-method