TY - JOUR
T1 - Breastfeeding Decision-Making Among Mothers with Opioid Use Disorder
T2 - A Qualitative Study
AU - Standish, Katherine R.
AU - Morrison, Tierney M.
AU - Wanar, Amita
AU - Crowell, Lisa
AU - Safon, Cara B.
AU - Colson, Eve
AU - Drainoni, Mari Lynn
AU - Colvin, Bryanne N.
AU - Friedman, Hayley
AU - Schiff, Davida M.
AU - Stulac, Sara
AU - Costello, Eileen
AU - Parker, Margaret
N1 - Publisher Copyright:
Copyright © 2023, Mary Ann Liebert, Inc.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: Factors that contribute to low initiation and continuation of breastfeeding among mothers with opioid use disorder (OUD) are poorly understood. Objective: To understand barriers and facilitators to breastfeeding initiation and continuation beyond the birth hospitalization for mothers with OUD. Materials and Methods: We conducted 23 in-depth, semistructured interviews with mothers with OUD who cared for their infants at home 1-7 months after birth. Our interview guide was informed by the Theory of Planned Behavior (TPB) framework, which has been used to understand decision-making regarding breastfeeding. An iterative approach was used to develop codes and themes. Results: Among 23 participants, 16 initiated breastfeeding, 10 continued after hospital discharge, and 4 continued beyond 8 weeks. We identified factors influencing breastfeeding decisions in the four TPB domains. Regarding attitudes, feeding intentions were based on beliefs of the healthiness of breastfeeding particularly pertaining to infant withdrawal or exposure to mothers' medications. Regarding social norms, breastfeeding was widely recommended, but mothers had varying levels of trust in medical professional advice. Regarding perceived control, infant withdrawal and maternal pain caused breastfeeding to be difficult, with decisions to continue modulated by level of outside support. Regarding self-efficacy, mothers weighed their own recovery and well-being against the constant demands of breastfeeding, impacting decisions to continue. Conclusion: Mothers with OUD face unique barriers to breastfeeding related to their infants' withdrawal as well as their own health, recovery, and social context. Overcoming these barriers may serve as future intervention targets for breastfeeding promotion among this high-risk population.
AB - Background: Factors that contribute to low initiation and continuation of breastfeeding among mothers with opioid use disorder (OUD) are poorly understood. Objective: To understand barriers and facilitators to breastfeeding initiation and continuation beyond the birth hospitalization for mothers with OUD. Materials and Methods: We conducted 23 in-depth, semistructured interviews with mothers with OUD who cared for their infants at home 1-7 months after birth. Our interview guide was informed by the Theory of Planned Behavior (TPB) framework, which has been used to understand decision-making regarding breastfeeding. An iterative approach was used to develop codes and themes. Results: Among 23 participants, 16 initiated breastfeeding, 10 continued after hospital discharge, and 4 continued beyond 8 weeks. We identified factors influencing breastfeeding decisions in the four TPB domains. Regarding attitudes, feeding intentions were based on beliefs of the healthiness of breastfeeding particularly pertaining to infant withdrawal or exposure to mothers' medications. Regarding social norms, breastfeeding was widely recommended, but mothers had varying levels of trust in medical professional advice. Regarding perceived control, infant withdrawal and maternal pain caused breastfeeding to be difficult, with decisions to continue modulated by level of outside support. Regarding self-efficacy, mothers weighed their own recovery and well-being against the constant demands of breastfeeding, impacting decisions to continue. Conclusion: Mothers with OUD face unique barriers to breastfeeding related to their infants' withdrawal as well as their own health, recovery, and social context. Overcoming these barriers may serve as future intervention targets for breastfeeding promotion among this high-risk population.
KW - Theory of Planned Behavior
KW - breastfeeding
KW - opioid use disorder
KW - opioid-exposed newborns
UR - http://www.scopus.com/inward/record.url?scp=85159761920&partnerID=8YFLogxK
U2 - 10.1089/bfm.2022.0226
DO - 10.1089/bfm.2022.0226
M3 - Article
C2 - 37115582
AN - SCOPUS:85159761920
SN - 1556-8253
VL - 18
SP - 347
EP - 355
JO - Breastfeeding Medicine
JF - Breastfeeding Medicine
IS - 5
ER -