Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Kathleen O'Connor Duffany

Second Advisor

Rafael Pérez-Escamilla

Abstract

Background: Despite the persistence of racial and ethnic disparities in breastfeeding in which Black mothers breastfeed at lower rates, little is known about Black fathers’ experiences with breastfeeding and breastfeeding support services (e.g., maternity hospital-based care, lactation specialty care). This thesis reports Black fathers’ perceptions of breastfeeding, influencers of breastfeeding, and breastfeeding support services in Connecticut using a qualitative, community-based participatory approach.Methods: The study’s focus group guide was co-developed with community partners and adapted from the Barrier Analysis Tool to identify breastfeeding facilitators, barriers, and service improvement areas. Per study design, all participants were fathers to a child under three years old, Connecticut residents, and self-identified as Black. The qualitative data were analyzed using rapid template analysis involving deductive and inductive coding. Results: Focus groups revealed factors influencing breastfeeding at the individual, interpersonal, institutional, and community/policy levels. Identified breastfeeding facilitators included high paternal breastfeeding knowledge, paternal breastfeeding involvement, parents’ shared decision-making, extensive maternity hospital discharge support, ongoing breastfeeding support into the postnatal period, community breastfeeding resources, and designated spaces for public breastfeeding. Noted breastfeeding barriers include low paternal breastfeeding knowledge, familial discouragement, insufficient prenatal breastfeeding education, exclusion of the father from breastfeeding support services, and stigma against breastfeeding in public. Conclusions: These findings illustrate the current climate for breastfeeding in Connecticut as perceived by Black fathers and help to contextualize racial and ethnic disparities in breastfeeding. Practice implications include the desire for ongoing, personalized breastfeeding education coordinated from prenatal to postnatal periods and the need for breastfeeding support services to directly engage fathers as breastfeeding participants and decision-makers.

Comments

This is an Open Access Thesis.

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