Study Explores Racial, Ethnic Disparities in Breastfeeding

Although breastfeeding is widely accepted as the healthiest choice for infants, significant disparities in breastfeeding persist. Poverty, educational levels, and breastfeeding initiation in the hospital may help explain which women initiate breastfeeding with newborn babies and which don’t, according to a study published in Pediatrics.

According to the study, Spanish-speaking Hispanic mothers were most likely to initiate breastfeeding in the hospital, with 91% attempting nursing. English-speaking Hispanic mothers attempted breastfeeding at a rate of 90%, compared to 78% of white mothers and 61% of black mothers.

Why Some Mothers May Not Initiate Breastfeeding

For the study, researchers analyzed data on 1,636 mother-child pairs who participated in the Community and Child Health Network study, assessing intent to breastfeed after birth and following up one and six months after birth. Participants delivered babies at hospitals in Los Angeles, California; Washington, D.C.; Baltimore, Maryland; and Lake County, Illinois.

The study looked at factors such as breastfeeding initiation, maternal desire to breastfeed, and length of breastfeeding in addition to demographic data such as maternal age and income, household composition, maternal postpartum depression, smoking, belief in the value of breast milk, family breastfeeding history, and socioeconomic status.

According to study results, mothers who had received more education were more likely to breastfeed, and high levels of poverty reduced the likelihood that a woman would breastfeed. The study also revealed that family history played a critical role. Hispanic women were far more likely than white or black women to have a relative who breastfed, and this previous exposure increased the likelihood that these women would breastfeed their own babies. This, the study’s authors note, is an important data point, since Hispanic women are often similarly situated to black women both socioeconomically and educationally.

Hospital policies and the behavior of hospital staff also played a key role. Researchers found that black women were nine times as likely to be offered formula in the hospital as white women were, and women who were offered formula were less likely to breastfeed their babies.

Breastfeeding Recommendations

The American Academy of Pediatrics supports breast milk as the normal diet for human babies and advises mothers to exclusively breastfeed their babies, offering no other food or liquids, until about six months. Thereafter, the AAP advises mothers to continue breastfeeding until the baby is at least one year old, while gradually introducing solid foods. The organization recommends nursing newborns on demand—usually eight to 12 times per day.

Only about half of all American children are still receiving breast milk at six months, though research consistently shows that breast milk provides a number of benefits to infants. Breastfeeding is recommended by the AAP whenever possible.

Benefits of breast milk include:

• A reduced risk of sudden infant death syndrome (SIDS)
• A reduction in the risk of allergies, celiac disease, and inflammatory bowel disease (IBS)
• Lower rates of obesity
• Lower rates of diabetes
• Lower rates of childhood lymphoma and leukemia
• Increased resistance to common illnesses, such as respiratory tract infections, gastrointestinal tract infections, ear infections, and pneumonia
• A lower risk of necrotizing entercolitis (a potentially lethal intestinal infection to which premature babies are especially vulnerable)
• Breastfeeding may lead to better neurodevelopmental outcomes and higher IQ; however, some research suggests this might be due to other factors associated with breastfeeding, such as higher maternal IQ or increased parental involvement.

References:

1. Breastfeeding and the use of human milk. (2012). Pediatrics, 129(3). doi:10.1542/peds.2011-3552
2. In-hospital formula feeding, family history help explain breastfeeding gaps. (2016, July 19). Retrieved from http://www.eurekalert.org/pub_releases/2016-07/vt-iff071916.php
3. Mckinney, C. O., Hahn-Holbrook, J., Chase-Lansdale, P. L., Ramey, S. L., Krohn, J., Reed-Vance, M., . . . Shalowitz, M. U. (2016). Racial and ethnic differences in breastfeeding. Pediatrics. doi:10.1542/peds.2015-2388
4. Where we stand: Breastfeeding. (2015, November 21). Retrieved from https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Where-We-Stand-Breastfeeding.aspx

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