Objectives To examine perceptions, experiences, and attitudes towards breastfeeding among Hispanic women living in rural Washington State. Methods Twenty parous Hispanic women of low acculturation, aged 25–48 years and residents in rural Washington State participated in an exploratory, face-to-face interview. Interviews were audio-recorded, translated and transcribed, and analyzed using a thematic content analysis approach. Results Nine emergent themes were grouped into three overarching categories: (1) Breast is best; (2) Hispanic cultural and familial expectations to breastfeed; and (3) Adapting to life in the United States: cultural norms in conflict. Women said they were motivated to breastfeed because of their knowledge and observations of its health benefits for mother and child. They said breastfeeding is ingrained in their Hispanic cultural heritage, and infant feeding choices of female family members were particularly influential in women’s own decision to breastfeed. Women said they experienced embarrassment about breastfeeding in the United States and as a result, often chose to initiate formula feeding as a complement so as to avoid feelings of shame. Additionally, they faced economic pressure to work, key barriers for continued breastfeeding among Hispanics in the United States. Conclusions for Practice Knowledge of the benefits of breastfeeding for mother and child and longstanding cultural practices of breastfeeding are not enough to encourage exclusive breastfeeding to 6 months among this rural Hispanic population. Continued support through family-level interventions as well as work place policies that encourage breastfeeding are needed for rural Hispanics to reach optimal breastfeeding rates. © 2016, Springer Science+Business Media New York.

Rural populations Immigrant health health disparities breastfeeding Hispanic/Latino

human epidemiology statistics and numerical data rural population Mother-Child Relations Maternal Behavior social support ethnology procedures Washington Hispanic Americans Breast Feeding interview United States Young Adult Humans migrant psychology Hispanic Interviews as Topic Emigrants and Immigrants Acculturation Socioeconomic Factors socioeconomics Mothers cultural factor Health Knowledge, Attitudes, Practice mother adult Choice Behavior postnatal care decision making attitude to health mother child relation