Factors Influencing Mothers’ Own Milk Provision Among Spanish-Speaking Latina Mothers of Preterm Infants

BACKGROUND: Lactation support for Latina Spanish-speaking mothers of preterm infants in the United States remains suboptimal. OBJECTIVES: We used the theory of planned behavior (TPB) to investigate factors that facilitate or hinder mother's own milk (MOM) provision among Spanish-speaking Latina mothers of preterm infants. METHODS: We conducted in-depth interviews in Spanish with mothers of early preterm infants (born < 34 weeks' gestation) from two Level III neonatal units, in Massachusetts and Colorado, 2 to 6 months after hospital discharge. Guided by the TPB domains-attitudes, perceived control, self-efficacy, and social norms-we designed the interview guide and codebook. Themes were developed deductively and iteratively. RESULTS: We interviewed 21 Spanish-speaking mothers from Central America, the Caribbean, and Mexico. Social and cultural factors influencing MOM provision were evident across all TPB domains. For attitudes, mothers valued direct breastfeeding over pumping. For perceived control, unmet social needs hindered continuation of MOM provision, while lack of language-concordant care and suboptimal interpreter services affected hospital lactation education and support. Regarding self-efficacy, mothers viewed making MOM as a duty, and that support from partners and family boosted confidence in their ability to provide MOM. For social norms, cultural customs and beliefs shaped mothers' intent to provide MOM, with both positive and negative customs and beliefs playing a role. CONCLUSION: Lactation support practices for Spanish-speaking Latina mothers of preterm infants should leverage mothers' social supports and positive cultural norms and address language barriers, misbeliefs, and unmet social needs that hinder continuation of MOM provision.