BACKGROUND Using qualitative methods, this case study of an inner-city family practice explores how a group of eight minority women and their families decided whether to breast-feed or bottle-feed their infants and how the office and hospital settings affected this decision-making process. METHODS The methods included depth interviews, a focus group interview, and participant observation. RESULTS Five key themes emerged from the data: 1) knowledge alone does not ensure any particular decision, 2) support is primarily from family networks in this group, with health care providers in a secondary role, 3) mothers and their families want to provide their infants with quantifiably sufficient nourishment, 4) physical and psychosocial satisfaction with the feeding method chosen is important, and 5) breast-feeding in public is not acceptable. CONCLUSIONS If the nutritional and bonding advantages do not outweigh the social embarrassment, inconvenience, and insecurity of breast-feeding, then bottle-feeding is chosen as the preferred method of infant feeding in this case study. Timely interventions in the postpartum period by providers often play a critical role in the initial success of breast-feeding.