Racial and Ethnic Differences in Breastfeeding

Abstract

on behalf of the Community Child Health Research Network abstract OBJECTIVES: Breastfeeding rates differ among racial/ethnic groups in the United States. Our aim was to test whether racial/ethnic disparities in demographic characteristics, hospital use of infant formula, and family history of breastfeeding mediated racial/ethnic gaps in breastfeeding outcomes. METHODS:We analyzed data from the Community and Child Health Network study (N = 1636). Breastfeeding initiation, postnatal intent to breastfeed, and breastfeeding duration were assessed postpartum. Hierarchical linear modeling was used to estimate relative odds of breastfeeding initiation, postnatal intent, and duration among racial/ethnic groups and to test the candidate mediators of maternal age, income, household composition, employment, marital status, postpartum depression, preterm birth, smoking, belief that "breast is best, " family history of breastfeeding, in-hospital formula introduction, and WIC participation.RESULTS: Spanish-speaking Hispanic mothers were most likely to initiate (91%), intend (92%), and maintain (mean duration, 17.1 weeks) breastfeeding, followed by English-speaking Hispanic mothers (initiation 90%, intent 88%; mean duration, 10.4 weeks) and white mothers (initiation 78%, intent 77%; mean duration, 16.5 weeks); black mothers were least likely to initiate (61%), intend (57%), and maintain breastfeeding (mean duration, 6.4 weeks). Demographic variables fully mediated disparities between black and white mothers in intent and initiation, whereas demographic characteristics and in-hospital formula feeding fully mediated breastfeeding duration. Family breastfeeding history and demographic characteristics helped explain the higher breastfeeding rates of Hispanic mothers relative to white and black mothers.CONCLUSIONS: Hospitals and policy makers should limit in-hospital formula feeding and consider family history of breastfeeding and demographic characteristics to reduce racial/ ethnic breastfeeding disparities. Dr McKinney conceptualized the research questions, helped design the data collection instruments, conducted data collection, helped conduct the analyses, and drafted the initial and revised manuscripts; Dr Hahn-Holbrook helped conceptualize the research questions, draft the initial and revised manuscripts, and conduct the analyses; Dr Chase-Lansdale critically reviewed the initial manuscript; Dr Ramey helped design the data collection instruments, coordinated and supervised data collection, and critically reviewed the initial and revised manuscripts; Mrs Krohn helped design the data collection instruments and critically reviewed the initial manuscript; Mrs Vance helped design the data collection instruments, coordinated and supervised data collection, NIH

Breastfeeding History and Risk of Stroke Among Parous Postmenopausal Women in the Women's Health Initiative

“…Although this study's findings could not establish a causal relationship between breastfeeding and risk of stroke, health disparities surrounding stroke1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18 and breastfeeding rates52, 53, 54 persist. Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4.…”

“…Stroke is 1 of the leading causes of death among Hispanic and non‐Hispanic black women over 65 2, 4. These same groups of women also experience low breastfeeding rates 52, 53, 54…”

“…51 Also, whereas 83% of US women initiate breastfeeding soon after giving birth, only 55% of these women report any breastfeeding at 6 months postpartum, and 34% report any breastfeeding at 12 months postpartum 51. More importantly, breastfeeding rates vary by race/ethnicity and are lowest among non‐Hispanic black women with 64% initiating breastfeeding, followed by 35% breastfeeding at 6 months and 17% at 12 months postpartum; duration rates for Hispanic women are slightly higher at 51% at 6 months and 26% at 12 months postpartum but well below those of non‐Hispanic white women (56% and 31%, respectively) 52, 53, 54…”

Breastfeeding attitudes among adolescent mothers attending a nutrition breastfeeding support group

“…[5] An analysis of data from the Community and Child Health Network by McKinney and associates revealed that Spanish-speaking Hispanic mothers were more likely to initiate breastfeeding and have a positive maternal family history of breastfeeding compared to whites and non-Hispanic black. [15] Further research has demonstrated that not only do racial and ethnic disparities exist but they are further confounded by the lack of implementation of the Ten Steps to Successful Breastfeeding recommended as part of the Baby Friendly Hospital Initiative endorsed by the CDC. [16,17] Table 1 lists the Ten Steps to Successful Breastfeeding.…”

Essays on Culture and Early Childhood

“…So far, literature shows that breastfeeding practices vary across mother's birth place, ethnicity and race, even when they face similar socioeconomic conditions. (6,7,8,9,10,11,12) In addition, these practices are correlated with mother's participation in social activities (e.g. attendance to church), stigma around breastfeeding in public and gender roles beliefs, amongst others.…”