Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Kathleen O'Connor-Duffany

Second Advisor

Rafael Perez-Escamilla


Objective: Racial and ethnic disparities in breastfeeding persist in Connecticut, with Black and African American mothers breastfeeding at the lowest rate. A qualitative study of Black mothers in the Greater New Haven Area was conducted to understand the barriers and facilitators to breastfeeding. Methods: A qualitative design adapting the Barrier Analysis tool was used to conduct in-depth focus groups with Black mothers who did exclusively breastfeed for 3 months (EBF3) and Black mothers who did not exclusively breastfeed for 3 months (NEBF3). 3 focus groups were conducted with EBF3 participants and 3 focus groups were conducted with NEBF3 participants. Focus groups were recorded and transcripts were analyzed by a four-person research team. Results: Barriers and facilitators were categorized based on the ecological model at the following levels: policy, cultural, institutional, interpersonal, and individual. The major barriers include lack of awareness and access to workplace policies, sexualization of breastfeeding, lack of publicly-accessible lactation spaces, cultural bias against breastfeeding, inaccessible lactation support, unhelpful breastfeeding support, lack of lactation supplies, discouragement from social networks, returning to work and having to make substantial lifestyle changes. The major facilitators include staying home from work, generational breastfeeding, and having a strong support network. Conclusion: This study describes the additional barriers that Black mothers face when trying to breastfeed and the facilitators that can help mitigate difficulties. These findings help to contextualize racial and ethnic disparities in breastfeeding to inform public health practitioners in breastfeeding campaigns and program development.


This is an Open Access Thesis.

Open Access

This Article is Open Access