Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Anita J. Hunter, PhD, RN, FAAN, Chairperson; Jane M. Georges, PhD, RN; Kathy Shadle James, PhD, RN


Breastfeeding, Chronic illness, motherhood, nursing, women


Breastfeeding and Mothers with Chronic Health Conditions Breastfeeding may be most beneficial for women with specific chronic illness and may decrease the risk or prevent those illnesses from developing in their children. This study examined the initiation and duration rates of mothers identified as having asthma, hypertension, and diabetes; differences between the three groups in their efforts to breastfeed, and associations between determinants/outcomes of breastfeeding and behavioral beliefs, normative beliefs, and perceived control of mothers using Ajzen's Theory of Planned Behavior (TPB). A retrospective quantitative methodology was used to compare rates of initiation and duration, the differences between the three groups, and correlations of determinants/outcomes to the constructs of the TPB. A qualitative element identified continuation/discontinuation themes and was used to give further insight into the mothers' breastfeeding decisions. Fifty-three mothers, with asthma, hypertension or diabetes prior to the pregnancy were recruited into the study. The Breastfeeding Attrition Predictor Tool (BAPT), a 52-item valid and reliable Likert scale instrument was used to assess the mothers' behavior and normative beliefs and perceived control regarding breastfeeding. The BAPT also provided a section for demographic information. Descriptive statistics, ANOVA, and correlations were used to analyze the data. Findings included a breastfeeding initiation rate of 100% for all groups of mothers and a duration rate that exceeded the 2010 Healthy People recommendations. Mothers with asthma were found to higher Positive Breastfeeding Sentiment (PBS) than the other two groups. Women who endured a cesarean delivery reported lower levels of PBS. Women who breastfed their last child longer reported higher levels of Breastfeeding Control (BFC) along with those who reported more positive breastfeeding experiences with their last child. The recurring theme for continuing to breastfeed was the health of the baby, while discontinuing was self weaning of the baby or goals were achieved. Mothers with chronic health conditions face challenges of managing their chronic illness while dealing with all of the changes associated with pregnancy and breastfeeding. A better understanding of their efforts to breastfeed may help health care providers to develop, implement, and evaluate programs that support this vulnerable group of mothers.

Document Type

Dissertation: Open Access



Included in

Nursing Commons