A large urban hospital in Florida implemented changes to achieve the Baby-Friendly Hospital Initiative (BFHI) designation in 2015 resulting in an increase of exclusive breastfeeding rates at hospital discharge; however, African American women continue to have the lowest rates overall. Qualitative interviews were conducted with 20 African American women who received prenatal care at a low-income women’s clinic and gave birth at an affiliated BFHI hospital. Using a medical anthropology analytical framework to examine predisposing, enabling, and service-related factors that affect breastfeeding, this study investigated interpersonal, sociocultural, and institutional barriers to breastfeeding. Common challenges experienced by participants included lack of maternity leave from work, lack of access to electric pumps, social pressures to initiate formula supplementation, fears that breastfeeding renders infants overly dependent on their mother’s care, and a lack of breastfeeding role models and/or support networks to normalize longer-term breastfeeding. We conclude that efforts to increase breastfeeding rates for African American women and promote culturally sensitive interventions must address underlying socioeconomic and structural barriers, women’s perceptions of breastfeeding benefits and difficulties, and the need for improvements in postnatal lactation and doula support to foster a more inclusive culture of breastfeeding.

佛罗里达州的一家大型城市医院为实现2015年“爱婴医院倡议”而进行了更改，导致出院时的纯母乳喂养率增加；但是，非洲裔美国妇女总体上仍然是最低的。对20名在低收入妇女诊所接受产前护理并在附属BFHI医院分娩的非洲裔美国妇女进行了定性访谈。这项研究使用医学人类学分析框架来检查影响母乳喂养的易感性，促成因素和与服务相关的因素，从而调查了人际，社会文化和机构性因素对母乳喂养的影响。参与者遇到的常见挑战包括：缺少产假，无法使用电动泵，发起配方奶粉的社会压力，担心母乳喂养使婴儿过度依赖母亲的照顾以及缺乏母乳喂养的榜样和/或支持网络来规范长期母乳喂养。我们得出结论，为提高非裔美国人妇女的母乳喂养率和促进对文化敏感的干预而做出的努力必须解决潜在的社会经济和结构性障碍，妇女对母乳喂养的好处和困难的认识，以及改善产后哺乳和导尿的必要性以培育更具包容性的文化母乳喂养。