Poverty and Breastfeeding: Comparing Determinants of Early Breastfeeding Cessation Incidence in Socioeconomically Marginalized and Privileged Populations in the FiNaL Study

Abstract

Purpose: Infant feeding differences are strongly tied to socioeconomic status. The goal of this study is to compare determinants of early breastfeeding cessation incidence in socioeconomically marginalized (SEM) and socioeconomically privileged (SEP) populations, focusing on birthing parents who intended to breastfeed.Methods: This cohort study includes data from 451 birthing parents in the Canadian province of Newfoundland and Labrador who reported intention to breastfeed in the baseline prenatal survey. Multivariate logistic regression techniques were used to assess the determinants of breastfeeding cessation at 1 month in both SEM and SEP populations.Results: The analysis data included 73 SEM and 378 SEP birthing parents who reported intention to breastfeed at baseline. At 1 month, 24.7% (18/73) in the SEM group had ceased breastfeeding compared to 6.9% (26/378) in the SEP group. In the SEP population, score on the Iowa Infant Feeding Attitude Scale (IIFAS) (odds ratio [OR] 3.33, p=0.01) was the sole significant determinant. In the SEM population, three significant determinants were identified: unpartnered marital status (OR 5.10, p=0.05), <1 h of skin-to-skin contact after birth (OR 11.92, p=0.02), and negative first impression of breastfeeding (OR 11.07, p=0.01).Conclusion: These results indicate that determinants of breastfeeding cessation differ between SEM and SEP populations intending to breastfeed. Interventions intended on improving the SEM population's postpartum breastfeeding experience using best practices, increasing support, and ensuring at least 1 h of skin–skin contact may increase breastfeeding rates.

The Triad Mother-Breast Milk-Infant as Predictor of Future Health: A Narrative Review

“…Moreover adverse social determinants could affect breastfeeding initiation and early cessation as evaluated in a cohort study by Newhook at al. [ 161 ]. In fact, a socioeconomically disadvantaged population with low levels of education and income seems to be much less likely to breast-fed than their peers with higher levels of income and education [ 161 ].…”

“…[ 161 ]. In fact, a socioeconomically disadvantaged population with low levels of education and income seems to be much less likely to breast-fed than their peers with higher levels of income and education [ 161 ]. In this kind of population, community support systems, such as trained health workers, lactation consultants, and community leaders, become essential to sustain breastfeeding [ 162 ].…”

Framing the discussion of microorganisms as a facet of social equity in human health

“…Antenatal paid leave practices vary globally by time and rate of compensation [35], and differences in ability to take parental leave may be reflective of SES disparities [36,37]. A lack of antenatal leave reduces the likelihood and duration of breastfeeding [38], especially in low-SES households [39], which are less likely to initiate breastfeeding due to a lack of social support, inadequate care at the time of birth, and misconceptions about breastfeeding [40–42]. Providing access and increasing the duration of paid parental leave improves health outcomes for mothers and infants and increases the probability of breastfeeding [42,43], thus ensuring beneficial maternal microbial transfer.…”

Prenatal Lactation-Focused Motivational Interviewing for Enhancing Breastfeeding Initiation, Exclusivity, and Duration: Feasibility and Preliminary Outcomes

“…To illustrate, households in Appalachia in 2015 earned incomes approximately $15,000 less than the national average, and are more likely to live below the poverty line (Appalachian Regional Commission, 2017). Given that poverty is a strong correlate of not breastfeeding (Scott et al, 2006) and early cessation of breastfeeding (Newhook et al, 2017), low-income women are an important public health target. Compounding the low income of many women in Appalachia is poor access to prenatal care (Snyder & Thatcher, 2014).…”

“…It is time we move forward with the design, implementation and evaluation of programs that address the breastfeeding needs of all. (p. 13) Accordingly, expansions of this line of research should use MI to specifically target historically underserved populations, such as American Indians, African Americans, veterans and active duty service members (Pérez-Escamillo & Sellen, 2015), LGBTQ individuals (Farrow, 2014), women with disabilities (Redshaw, Malouf, Gao, & Gray, 2013), and lowincome women (Newhook et al, 2017), among others. Of course, cultural adaptations should be made to the MI intervention as necessary (Wilhlem et al, 2015).…”