Background: Although breastfeeding rates in Hawai`i are among the highest in the United States and meet the United States Healthy People 2010 objectives (a statement of national health objectives), these rates are not consistent in all segments of the population. Among the Native Hawaiian population, breastfeeding rates are 25–30% lower than the general population. This disparity (inequality) has not been well researched. A multiphased ethnographic study was undertaken to better understand the nature and factors influencing this disparity. The aim of this phase of the study was to describe the perceptions of Native Hawaiian women about the influences affecting the breastfeeding disparities found in their community. Method: Participants were recruited through a community health centre, purposeful sampling continued until saturation was reached. Interviews were conducted with Native Hawaiian mothers (N=20) who had breastfed at least one child. The analysis was guided by the participants’ voices; the data analysis remained grounded in the participants’ view. Data were coded, categorized, and conceptually grouped into patterns.

Results: The patterns were identifying resources, difficulty breastfeeding, and unmet expectations. Resources which functioned as supports or assets to the breastfeeding experience included knowledge, prior experience, motivation, support, equipment, and empathy. Breastfeeding was “hard,” because of the physical problems with the woman’s breast, discomfort, and time demands. Unmet expectations included a discrepancy in values, an assumption of participant knowledge, lifestyle adjustments, and the value of organizational support.

Conclusions: Traditionally, women breastfed in a supportive environment that was not fully available to the study participants. Valuing traditional practices in the context of current influences may improve breastfeeding rates among Native Hawaiian women; therefore, the health of this community.

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