Breastfeeding Experience and Maternal Self-Efficacy during COVID-19: Differences between Racial Minority and White Women

Introduction: This study explored breastfeeding experiences and maternal self-efficacy among postpartum individuals during the first 6 months of the COVID-19 pandemic and identified differences among racial minority and white women before and after 6 weeks postpartum. Methods: Using a cross-sectional study design, we collected survey data from 575 postpartum individuals in the USA who had given birth after February 1, 2020. Data were collected from June to July 2020 as part of the COVID-19 M.A.M.A.S. study. The current study included participant responses to the Breastfeeding Experience Scale (BES) and the Being a Mother Scale-13 (BAM-13). Descriptive statistics described responses to the BES and BAM-13 and Wilcoxon rank sum tests compared responses of white (N = 504) and racial minority (N = 71) participants at ≤6 weeks and >6 weeks postpartum. Results: The aggregated mean BES and BAM-13 scores were 41.5 (10.98) (18–90 scale) and 12.92 (6.3) (0–39 scale), respectively. Racial minority participants ≤6 weeks postpartum reported more negative breastfeeding experiences (BES M = 47.3 vs. 40.5, p = 0.005) and worse maternal self-efficacy (BAM M = 15.0 vs. 11.6, p = 0.013) than white participants. For those 6 weeks or less postpartum, significant differences between racial groups were observed in BES subdomains including mother concern (p = 0.009), milk insufficiency (p = 0.006), and breast concern (p = 0.013). A moderate positive correlation was found between BES and BAM scores across all groups (r = 0.47; p < 0.001), suggesting a direct relationship between breastfeeding experiences and maternal self-efficacy. Conclusion: These findings highlight the need for early, culturally competent, and integrated postpartum care that addresses both breastfeeding challenges and maternal mental health. Nurses and clinicians should prioritize screening and support for nonwhite, racial minority mothers in the early postpartum period to improve breastfeeding and maternal self-efficacy.