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Dissertation/Thesis Abstract

Nourishing choice: Using latent class analysis in mixed methods to identify factors promoting long-term breastfeeding among primiparous women in Colorado
by Cooper, Sara Lisa Drucker, Ph.D., University of Colorado at Denver, 2012, 219; 3519443
Abstract (Summary)

To date, little research has been done on the determinants of long-term breastfeeding among women who are older, better-educated and have higher socio-economic status. Meanwhile, in spite of these mothers' relative breastfeeding success, their breastfeeding rates still fall short of national goals. This suggests that other latent factors or structural barriers influence breastfeeding behaviors in new mothers. The goal of this research was to identify factors critical to breastfeeding success and to devise strategies designed to increase breastfeeding duration not only in women who do not face the barriers of low SES or educational attainment, but for all new mothers.

This study employed a mixed methods design study which combined Latent Class Analysis (LCA) with semi-structured interviews. Colorado PRAMS data from 2009-2010 were used to study primiparous women with characteristics associated with long-term breastfeeding, while qualitative interviews among long-term breastfeeders determined the factors that influenced breastfeeding duration and exclusivity. Despite similar characteristics, women in these two groups were not universally successful in their breastfeeding efforts.

The LCA identified a non-linear relationship between maternal age and breastfeeding duration, which was further explored in qualitative interviews. Interviews revealed that employment status was critical in this unique relationship. For women ages 29-31, breastfeeding took precedence over employment, regardless of job status. Women in this group were least likely to return to work, and more likely to continue breastfeeding beyond personal goals. Women over age 35 were more likely to return to work full-time, and less likely to deviate from individual breastfeeding goals. These results confirm the importance of employment status in a women's ability to breastfeed long-term, and provide insight into how employment may interact with other maternal characteristics to support or to limit breastfeeding duration.

Both the LCA and qualitative analyses revealed differences in hospital-based experiences directly related to new mothers' ability to establish breastfeeding best-practices in the hospital, which was strongly associated with long-term breastfeeding. A three-path model of breastfeeding experiences was developed based on the results of this study. The model provides important direction for the creation of new interventions to improve the consistency and quality of institutional-based breastfeeding support.

Indexing (document details)
Advisor: Tracer, David
Commitee: Gujral, Indira, Scandlyn, Jean, Weddig, Jennifer
School: University of Colorado at Denver
Department: Health and Behavioral Sciences
School Location: United States -- Colorado
Source: DAI-B 74/01(E), Dissertation Abstracts International
Subjects: Behavioral psychology, Public health, Epidemiology
Keywords: Breastfeeding, Hospital-based support, Latent class analysis
Publication Number: 3519443
ISBN: 978-1-267-52409-6
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