Maternal and Child Health Journal

, Volume 16, Issue 8, pp 1672–1678 | Cite as

Maternity Care Practices and Breastfeeding Experiences of Women in Different Racial and Ethnic Groups: Pregnancy Risk Assessment and Monitoring System (PRAMS)

  • Indu B. Ahluwalia
  • Brian Morrow
  • Denise D’Angelo
  • Ruowei Li
Article

Abstract

Research shows that maternity care practices are important to promoting breastfeeding in the early post partum period; however, little is known about the association between maternity care practices and breastfeeding among different racial and ethnic groups. We examined the association between maternity care practices and breastfeeding duration to ≥10 weeks overall and among various racial and ethnic groups using data from the Pregnancy Risk Assessment and Monitoring System (PRAMS). PRAMS is a state, population-based surveillance system that collects information on maternal behaviors. We used maternity care practices data from 11 states and New York City with response rates ≥70% from 2004 to 2006. Multiple maternity care practices were examined and the analysis adjusted for demographic characteristics, participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), lifestyle, and infant variables. The outcome variable for multivariable analysis was breastfeeding duration to <10 weeks or ≥10 weeks. PRAMS data show that 22.1% of women did not breastfeed, about 27.7% breastfed for <10 weeks and 50.2% breastfed for ≥10 weeks. Breastfeeding patterns varied with white and Hispanic women reporting highest breastfeeding initiation and duration prevalence. Overall, practices positively associated with ≥10 duration were: breastfeeding initiated within the first hour after birth (adjusted OR [AOR] = 1.29; 95% CI: 1.16–1.45); fed breast milk only (AOR = 2.40; 95% CI: 2.15–2.68); breastfed on demand (AOR = 1.23; 95% CI 1.08–1.40) and receiving telephone support (AOR = 1.20; 95% CI: 1.03–1.39). Maternity care practices associated with breastfeeding to ≥10 weeks varied across three racial/ethnic groups. One practice, that of giving newborns breast milk only, was positively associated with breastfeeding duration of ≥10 weeks across all three groups. Maternity care practices associated with breastfeeding continuation to ≥10 weeks varied by race/ethnicity. For example: breastfeeding within the first hour, baby given a pacifier, and assistance from hospital staff, were significantly associated with breastfeeding duration among black and white women and not Hispanics. The practice of breastfeeding on demand was significantly associated with breastfeeding to ≥10 weeks for black and Hispanic women and not for whites. Hospitals may want to examine the implementation of specific practices in relation to the cultural backgrounds of women to promote breastfeeding.

Keywords

Maternity care practices PRAMS Breastfeeding Race/ethnicity 

References

  1. 1.
    American Academy of Pediatrics. (1997). Work group on breastfeeding, breastfeeding and the use of human milk. Pediatrics, 100(6), 1035–1039.CrossRefGoogle Scholar
  2. 2.
    Ip, S., Chung, M., Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence report/technology assessment No. 153. Rockville: Agency for Healthcare Research and Quality.Google Scholar
  3. 3.
    Rubin, D. H., Leventhal, J. M., Krasilnikoff, P. A., et al. (1990). Relationship between infant feeding and infectious illness: A prospective study of infants during the first year of life. Pediatrics, 85, 464–471.PubMedGoogle Scholar
  4. 4.
    Kramer, M. S., Chalmers, B., Hodnett, E. D., et al. (2001). Promotion of breastfeeding intervention trial (PROBIT): A randomized trial in the Republic of Belarus. The Journal of the American Medical Association, 285(4), 413–420.CrossRefGoogle Scholar
  5. 5.
    Duncan, B., Ey, J., Holberg, C., Wright, A., Martinez, F., & Taussig, L. (1993). Exclusive breastfeeding for at least 4 months protects against otitis media. Pediatrics, 91, 867–872.PubMedGoogle Scholar
  6. 6.
    Raisler, J., Alexander, C., & O’Campo, P. (1999). Breastfeeding and infant illness: A dose-response relationship. American Journal of Public Health, 89, 25–30.PubMedCrossRefGoogle Scholar
  7. 7.
    Ball, T. M., & Wright, A. L. (1999). Health care costs of formula-feeding in the first year of life. Pediatrics, 103, 870–876.PubMedGoogle Scholar
  8. 8.
    Bartick, M., & Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: A pediatric cost analysis. Pediatrics. doi: 10.1542/peds.2009-1616.
  9. 9.
    Harder, T., Bergmann, R., Kallischnigg, G., & Plagemann, A. (2005). Duration of breastfeeding and risk of overweight: A meta-analysis. American Journal of Epidemiology, 162(5), 397–403.PubMedCrossRefGoogle Scholar
  10. 10.
    Arnez, S., Ruckerl, R., Kolestzko, B., & Von Kries, R. (2004). Breastfeeding and childhood obesity: A systematic review. International Journal of Obesity, 28(10), 1247–1256.CrossRefGoogle Scholar
  11. 11.
    Anderson, J. W., Johnstone, B. M., & Remley, D. T. (1999). Breastfeeding and cognitive development: A meta-analysis. The American Journal of Clinical Nutrition, 70(4), 525–535.PubMedGoogle Scholar
  12. 12.
    Angelsen, N. K., Vik, T., Jacobson, G., & Bakketeig, L. S. (2001). Breastfeeding and cognitive development at age 1 and 5 years. Archives of Disease in Childhood, 85(3), 183–188.PubMedCrossRefGoogle Scholar
  13. 13.
    Kramer, M. S., Aboud, F., Mironova, E., et al. (2008). Breastfeeding and child cognitive development: New evidence from a large randomized trial. Archives of General Psychiatry, 65(5), 578–584.PubMedCrossRefGoogle Scholar
  14. 14.
    Oddy, W. H., Kendell, G. E., Li, J., Jacoby, P., et al. (2010). The long term effects of breastfeeding on child and adolescent mental health: A pregnancy cohort study followed for 14 years. Journal of Pediatrics, 156(4), 568–574.PubMedCrossRefGoogle Scholar
  15. 15.
    Cancer CGoHFiB. (2002). Breast cancer and breastfeeding: Collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973 women without the disease. Lancet, 360(9328), 187–195.CrossRefGoogle Scholar
  16. 16.
    Schwarz, E. B., Ray, R. M., Stuebe, A. M., et al. (2009). Duration of lactation and risk factors for maternal cardiovascular disease. Obstetrics and Gynecology, 113(5), 974–982.PubMedGoogle Scholar
  17. 17.
    Li, R., Darling, N., Maurice, E., et al. (2005). Breastfeeding rates in the United States by characteristics of the child, mother, or family: The 2002 National Immunization Survey. Pediatrics, 115, e31–e37.PubMedCrossRefGoogle Scholar
  18. 18.
    Hurley, K. M., Black, M. M., Papas, M. A., et al. (2008). Variation in breastfeeding behaviors, perceptions, and experiences by race/ethnicity among a low-income statewide sample of special supplemental nutrition program for women, infants, and children (WIS) participants in the US. Maternal and Child Nutrition, 4, 95–105.PubMedCrossRefGoogle Scholar
  19. 19.
    Gill, S. L. (2009). Breastfeeding by Hispanic Women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38, 244–252.PubMedCrossRefGoogle Scholar
  20. 20.
    Baby-Friendly USA, Inc. (2009). Baby friendly hospital initiative in the US. Available at: http://www.babyfriendlyusa.org/eng. Accessed June 3, 2009.
  21. 21.
    Powers, N. G., Naylor, A. J., & Wester, R. A. (1994). Hospital policies: Crucial to breastfeeding success. Seminars in Perinatology, 18(6), 517–524.PubMedGoogle Scholar
  22. 22.
    Saadeh, R., & Akre, J. (1996). Ten steps to successful breastfeeding: A summary of the rationale and scientific evidence. Birth, 23(3), 154–160.PubMedCrossRefGoogle Scholar
  23. 23.
    DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2001). Maternity care practices: Implications for breastfeeding. Birth, 28(2), 94–100.PubMedCrossRefGoogle Scholar
  24. 24.
    DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2008). Effect of maternity-care practices on breastfeeding. Pediatrics, 122, S43–S49.PubMedCrossRefGoogle Scholar
  25. 25.
    Centers for Disease Control and Prevention. (2008). Breastfeeding-related maternity practices at hospitals and birth centers—US, 2007. MMWR Morbidity and Mortality Weekly Report, 57(23), 621–625.Google Scholar
  26. 26.
    Rosenberg, K. D., Eastham, C. A., Kasehagen, L. J., & Sandoval, A. P. (2008). Marketing infant formula through hospitals: The impact of commercial hospital discharge packs on breastfeeding. American Journal of Public Health, 98(2), 290–295.PubMedCrossRefGoogle Scholar
  27. 27.
    Merten, S., Dratva, J., & Ackermann-Liebrich, U. (2005). Do baby-friendly hospitals influence breastfeeding duration on a national level? Pediatrics, 11, e702–e708. doi: 10.1542/peds.2005-0537.
  28. 28.
    Perez-Escamila, R. (2007). Evidence based breastfeeding promotion: The baby-friendly hospital initiative. Journal of Nutrition, 137, 484–487.Google Scholar
  29. 29.
    Donnelly, A., Snowden, H. M., Renfrew, M. J., & Woolridge, M. W. (2000). Commercial hospital discharge packs for breastfeeding women. Cochrane database of systematic reviews, 2:CD002075.Google Scholar
  30. 30.
    Howard, C., Howard, F., Lawrence, R., Andresen, E., BeBlick, E., & Weitzman, M. (2009). Office prenatal formula advertising and its effect on breastfeeding patterns. Obstetrics and Gynecology, 95, 296–303.CrossRefGoogle Scholar
  31. 31.
    Bartick, M., Stuebe, A., Shealy, K. R., Walker, M., & Grummer-Strawn, L. (2009). Closing the quality gap: Promoting evidence-based breastfeeding care in the hospital. Pediatrics, 124(4), e793–e802.PubMedCrossRefGoogle Scholar
  32. 32.
    Gorman, J. R., Madlensy, L., Jackson, D. J., Ganiats, T. G., & Boies, E. (2007). Early postpartum breastfeeding and acculturation among Hispanic Women. Birth, 34(4), 308–315.PubMedCrossRefGoogle Scholar
  33. 33.
    Holmes, A. V., Auinger, P., & Howard, C. R. (2011). Combination feeding of breast milk and formula: Evidence for shorter breastfeeding duration from the national health and nutrition examination survey. Journal of Pediatrics, 1–6.Google Scholar

Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2011

Authors and Affiliations

  • Indu B. Ahluwalia
    • 1
  • Brian Morrow
    • 1
  • Denise D’Angelo
    • 1
  • Ruowei Li
    • 2
  1. 1.Division of Reproductive HealthNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Division of Nutrition, Physical Activity, and ObesityNational Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and PreventionAtlantaUSA

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