Marshallese Women Who Move to U.S. Less Likely to Breastfeed, UAMS Researchers Find

By David Wise

UAMS researchers found Marshallese women living in the U.S. face numerous barriers to breastfeeding. Those barriers include a lack of familial and female support and breastfeeding education; balancing work responsibilities and pumping schedules; and stigmas regarding public perception of breastfeeding in public.

“Marshallese women in the U.S. have more barriers to breastfeeding than in the Republic of the Marshall Islands due to a lack of familial support and culturally tailored education in combination with U.S. cultural assimilation,” said Britni Ayers, an assistant professor in the UAMS College of Medicine and a researcher at the UAMS Institute for Community Health Innovation. “If we want to successfully address the maternal health crisis in Arkansas and the U.S., we must provide the necessary support and education all women need.”

According to the Centers for Disease Control and Prevention (CDC), breastmilk is the best source of nutrition for most infants, and breastfeeding reduces the risk of certain health conditions for both mothers and babies. However, according to the National Institutes of Health (NIH), the 20th century marked a dramatic shift from breastfeeding to formula use because of its convenience and ease for mothers to feed their babies. This shift in infant feeding practices became the standard for mainstream U.S. society.

Nearly 30% of participants in the UAMS study, Breastfeeding Intentions Among Pregnant Women Enrolled in a Healthy Start Program in Arkansas, reported they intended to exclusively breastfeed their infants, while more than half of the participants intended to breastfeed and use formula. However, only 18% of Marshallese participants intended to exclusively breastfeed, while 73% indicated the combination of breast milk and formula.

“Exclusive breastfeeding is not the norm in the U.S. because it is much easier and convenient to use formula, and many Marshallese moms worry they won’t have enough milk supply for their babies,” said Philmar Mendoza Kabu, a nurse educator at the UAMS Institute for Community Health Innovation. “Coupled with a lack of proper breastfeeding education, Marshallese women are more likely to accept this norm and use formula to feed their babies rather than breast milk.”

The UAMS Institute for Community Health Innovation works to ensure quality health care, education and community support for mothers in children. The institute is delivering prenatal care to rural areas throughout Arkansas through programs such as CenteringPregnancy and telehealth services, while providing culturally tailored education and support through community health workers and doula integration. To learn more about the institute, visit

UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,275 students, 890 medical residents and fellows, and five dental residents. It is the state’s largest public employer with more than 12,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit or Find us on Facebook, X (formerly Twitter), YouTube or Instagram.