ABSTRACT Background Mothers in the Special Supplemental Nutrition Programme for Women, Infants and Children (WIC) have lower breastfeeding rates than eligible non‐participating mothers. The availability of free formula is suspected to make WIC mothers more likely to shift to formula feeding when facing challenges in breastfeeding. Resilience could be a potential factor that facilitates mothers in sticking with their original breastfeeding plan. Methods To understand the complex relationship between breastfeeding and resilience among WIC mothers, we conducted a qualitative study in Chesapeake, Virginia, USA, with 23 in‐depth interviews and surveys in English and Spanish with WIC pregnant mothers. The interviews were transcribed, and the transcripts were analysed by independent researchers using NVivo 12. The descriptive statistics of the survey results were estimated. Results A conceptual framework was developed in which five dimensions of resilience were identified: optimism, emotion regulation, self‐efficacy, adaptation and social support. Resilience was a key factor among WIC mothers, moderating whether they intended to sustain breastfeeding or to switch to infant formula in the face of challenges. Pumping breastmilk was ranked as the first alternative to breastfeeding for most mothers. The common concerns about breastfeeding included milk supply (61%), baby's health (57%) and convenience (26%). Conclusions This framework provides initial evidence to explain the lower breastfeeding rate among WIC mothers and can guide WIC policies and interventions to promote breastfeeding in the programme. Future research is needed to understand the role of resilience in breastfeeding behaviours and outcomes in the WIC programme.
Neupane et al. (Mon,) studied this question.