The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal of the study was to answer the proposed research questions and examine whether there is a difference in breastfeeding intentions between Black women who receive peer support and those that do not. Peer support was offered during the prenatal period and contact was provided via Peer Group sessions. Significant variables from a bivariate analysis were included in a multivariable logistic regression model to determine the potential factors that were significantly associated with plans to breastfeed. The results showed that women were more than twice as likely to breastfeed their baby if they attended a peer support group versus those that did not attend a support group (OR= 2.17; 95%CI 5.35 - 13.38). Also, previous breastfeeding experience was found to be associated with plans to breastfeed with a significant odds ratio (OR=5.58; 95%CI 1.54 - 57.44).

The findings suggest that the prenatal period may be a critical time to influence a pregnant Black mother's decision to breastfeed. The study highlights the importance of social influences on the decision to breastfeed, and indicates the need for broadened community-based education for the promotion of breastfeeding. After adjusting for potential confounding variables, knowledge, beliefs, previous breastfeeding experience, income and support group attendance it was found that peer support plays an important role in mothers' infant feeding decisions. The WIC program serves as an important intervention site to promote breastfeeding among low-income, less educated and young Black women. Thus, health agencies such as WIC should be encouraged to provide opportunities to facilitate interventions that promote breastfeeding among Black mothers.


School of Public Health

First Advisor

Naomi Modeste

Second Advisor

Susanne Montgomery

Third Advisor

Maxine Taylor

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

African Continental Ancestry Group -- psychology; Breast Feeding -- ethnology; African Americans; Peer Group; Pregnant Women; Minority Groups -- statistics & numerical data



Page Count

ix; 72

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives