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  • Breastfeeding is a key nutritional behavior for infants during their first years of life. While prenatal breastfeeding intentions do not differ significantly between non-Hispanic Black and White mothers, the ability to meet those intentions decreases over time, and to a greater extent among Black mothers. This is partially due to environments inadequately supportive of individuals’ breastfeeding needs (i.e., not breastfeeding-friendly). The Community Readiness Assessment is a powerful tool to assess a community’s readiness to take action on pressing health issues. While it is frequently used to understand readiness to prevent negative health outcomes, this study explores how it can be used to understand readiness to promote breastfeeding friendliness and subsequently identify appropriate intervention strategies. Between November 2020 and June 2021, we conducted interviews with 23 key respondents in New Haven, Connecticut, representing five community sectors. Respondents scored five dimensions of readiness on a 9-point scale (1 = no awareness, 9 = community ownership). The overall community readiness score was 4.2, denoting the “preplanning” stage of readiness. The highest-scoring readiness dimension was “community knowledge about the issue” (mean score: 4.5), and the lowest-scoring dimension was “resources related to the issue” (mean score: 3.3). Small business owners reported the highest readiness score by sector (mean score: 5.0), while large employers reported the lowest (mean score: 3.1). Scores stratified by both sector and dimension revealed specific areas within the community where readiness-level-appropriate interventions could be implemented. This study highlights the benefit of assessing community readiness prior to intervention to identify tailored, equitable, and effective intervention strategies. © 2025 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

  • Breastfeeding has health benefits for both infants and mothers, yet Black mothers and infants are less likely to receive these benefits. Despite research showing no difference in breastfeeding intentions by race or ethnicity, inequities in breastfeeding rates persist, suggesting that Black mothers face unique barriers to meeting their breastfeeding intentions. The aim of this study is to identify barriers and facilitators that Black women perceive as important determinants of exclusively breastfeeding their children for at least 3 months after birth. Utilizing a Barrier Analysis approach, we conducted six focus group discussions, hearing from Black mothers who exclusively breastfed for 3 months and those who did not. Transcripts were coded starting with a priori parent codes based on theory-derived determinants mapped onto the Socioecological Model; themes were analysed for differences between groups. Facilitators found to be important specifically for women who exclusively breastfed for 3 months include self-efficacy, lactation support, appropriate lactation supplies, support of mothers and partners, prior knowledge of breastfeeding, strong intention before birth and perceptions of breastfeeding as money-saving. Barriers that arose more often among those who did not exclusively breastfeed for 3 months include inaccessible lactation support and supplies, difficulties with pumping, latching issues and perceptions of breastfeeding as time-consuming. Lack of access to and knowledge of breastfeeding laws and policies, as well as negative cultural norms or stigma, were important barriers across groups. This study supports the use of the Socioecological Model to design multicomponent interventions to increase exclusive breastfeeding outcomes for Black women.

Last update from database: 3/13/26, 4:15 PM (UTC)

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