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Supports and Barriers to the Provision of Human Milk by Mothers of African American Preterm Infants

Background: Mother's own milk (MOM) provides significant health benefits to very low birth-weight infants (VLBW, ⩽1500 g). However, 60% of African American (AA) women initiate lactation, and less than 35% provide MOM 6 months following the birth of their infant. Previous research focuses on term infants and is not specific to AA mothers of VLBW infants. Purpose: To qualitatively describe supports and barriers experienced by AA mothers while providing MOM for their VLBW infants. Methods: In this qualitative, descriptive study, we conducted semistructured interviews with AA mothers who provided MOM for their VLBW infant. Interviews were transcribed and manually coded concurrently with enrollment until theoretical saturation was achieved. Infant charts were reviewed for demographics, and triangulation with notes from the medical record by bedside nurse lactation consultants and other providers was performed to increase validity. Member checks were completed to ensure true meaning of responses. Results: Theoretical saturation was achieved after 9 interviews. Themes perceived to support provision of MOM included (1) Being a Mother; (2) Neonatal intensive care unit environment; (3) Community support; and (4) Useful resources. Themes that emerged as barriers to the provision of MOM were: (1) Maternal illness; (2) Milk expression; (3) Challenging home environment; and (4) Emotional distress. Implications for Practice: African American mothers report supports similar to published data but faced challenges not previously reported. These factors warrant attention by professionals who support lactation in this population. Implications for Research: Future research will address perceived barriers to improve provision of MOM and the quality of the lactation journey of AA mothers of preterm infants.