Breastfeeding in Context: African American Women's Normative Referents, Salient Identities, and Perceived Social Norms.

The purpose of this study was to describe social norms and salient social identities related to breastfeeding intentions among African American mothers in Washington, D.C. Five focus groups were held with 30 mothers who gave birth to a child between 2016 and 2019. Two coders conducted pragmatic thematic analysis. This study demonstrated that women hold different identities relevant to making infant feeding decisions, with mother being primary and race/ethnicity, age, and relationship status factoring into how they define themselves. Mothers drew their perceptions of what is common and accepted from family, friends, the "Black community," and what they perceived visually in their geographic area and heard from their health care providers. Mothers believed breastfeeding to be increasing in popularity and acceptability in African American communities in Washington, D.C., but not yet the most common or accepted mode of feeding, with some variability by socioeconomic status group. Implications for public health communication and social marketing are discussed.