Breastfeeding Perspectives: Reactions to Breastfeeding Imagery and Social Norms
Abstract Objectives Normative behaviors surrounding breastfeeding in public and the community can influence breastfeeding behaviors and inhibit sustained breastfeeding. The goal of this research is to better understand how a diverse group of women perceive images of racially/ethnically similar and different women breastfeeding. The aim is to uncover biases that may impede breastfeeding goals and promotion. Methods An online mixed-methods survey was completed by a sample of 144 mothers with children 2 years of age or younger. The survey included images of women of varying racial/ethnic groups breastfeeding in various settings. Respondents generated word associations for the images and indicated the appropriateness and ease of breastfeeding for each image. Responses were timed to ascertain cognitive dissonance. Supplemental questions examined descriptive, injunctive and group norms, in line with the Theory of Normative Social Behavior. Results A sample that included 42% non-White individuals and 31% Hispanic/Latino individuals, 73% of whom breastfed their most recent child, responded to the survey. On average, respondents took longer to respond to questions about the appropriateness of images of Black and Hispanic women breastfeeding than images of White or Asian women, even though their responses of appropriateness were roughly equal, demonstrating cognitive dissonance in norms and perceptions. Further, with direct comparisons, women were twice as likely to say breastfeeding was easier for an image of a White mother breastfeeding than an image of a Black or Hispanic mother breastfeeding, regardless of respondent racial/ethnic identity. Finally, differences in image appropriateness differed most significantly by the setting (i.e., public vs. private). Conclusions Women are influenced by racial/ethnic biases about breastfeeding ease and appropriateness as well as norms surrounding behaviors of breastfeeding in public settings or in front of others. Future work is needed to dismantle these biases that may influence breastfeeding behaviors and inequitably impact the feeding choice and health of mothers and infants. Funding Sources This research was funded by an internal research grant from Fairfield University.