Breastfeeding and Maternal Decency: A Qualitative Investigation of Infant Feeding Decisions among Low-Income Mothers

Helen J. Lee, Public Policy Institute of California (PPIC)

Despite evidence that breastfeeding confers benefits for infants, many mothers in the U.S. choose to formula feed, particularly low-income and minority women. While much is known about the correlates of breastfeeding behavior, few studies have examined how social networks and broader socio-cultural ideologies influence infant feeding decisions. Drawing from 29 semi-structured interviews and a focus group discussion among low-income, inner-city mothers in Philadelphia, I present mothers’ perspectives on their choice of infant feeding method. This paper describes the roles informal and formal social networks play in decision-making and illustrates how competing forms of knowledge and normative ideas shape mothers’ decisions, including their perceptions about the acceptability of breastfeeding in the public realm and in their private lives. The analysis focuses on the contradictions that breastfeeding embodies, where women must balance the demands of motherhood, medical advice that breastfeeding is “best,” and social taboos against public exposure of intimate body parts.