Maternal and Child Health Journal

, Volume 22, Issue 9, pp 1260–1277 | Cite as

Acculturation and Breastfeeding Among Hispanic American Women: A Systematic Review

  • Galya BigmanEmail author
  • Anna V. Wilkinson
  • Adriana Pérez
  • Nuria Homedes
Review Paper


Introduction Hispanic immigrants are more likely to breastfeed than are Hispanics born in the US, in part due to their acculturation. This paper aims to systematically review the existing literature on the association between acculturation and Hispanics’ breastfeeding behaviors. Methods The systematic search used major databases such as Medline and PubMed, and it followed the PRISMA checklist. The scientific quality of the studies was rated using the Quality Assessment Tool for Quantitative Studies. Results We identified 1943 potential citations, of which 18 studies met the eligibility criteria. Overall, while 13 studies suggested that high-acculturated Hispanics were less likely to breastfeed compared with low-acculturated, five studies did not find significant evidence of such an association. Moreover, 12 studies used a static measure or a linear scale, which is not optimal; only three studies utilized bi/multidimensional scales to assess acculturation. Intention to breastfeed was examined in six studies, but the results were inconsistent. Breastfeeding initiation was examined in 11 studies, and two out of eight studies that examined breastfeeding duration, specifically analyzed exclusive breastfeeding at 6 months. Discussion Our results agree with the general hypothesis that higher acculturation is inversely related to breastfeeding rates, independently of income. Researchers used different methodologies to study acculturation and breastfeeding practices, limiting our ability to reach more detailed conclusions. Owing to the lack of a standard methodology for measuring acculturation, future studies should utilize bi/multidimensional scales when studying breastfeeding, in particular, in relation to breastfeeding intention and exclusive breastfeeding at 6 months; preferably according to Hispanic subgroups.


Acculturation Breastfeeding Hispanics Systematic review 



We would like to thank our librarians for their assistance with the systematic review study.


This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. Ahluwalia, I. B., D’Angelo, D., Morrow, B., & McDonald, J. A. (2012). Association between acculturation and breastfeeding among Hispanic women: Data from the pregnancy risk assessment and monitoring system. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 28(2), 167–173. Scholar
  2. Anderson, A. K., Damio, G., Himmelgreen, D. A., Peng, Y. K., Segura-Perez, S., & Perez-Escamilla, R. (2004). Social capital, acculturation, and breastfeeding initiation among Puerto Rican women in the United States. Journal of Human Lactation: Official Journal of International Lactation Consultant Association, 20(1), 39–45. Scholar
  3. Andrews, A. R., 3rd, Bridges, A. J., & Gomez, D. (2013). A multi-study analysis of conceptual and measurement issues related to health research on acculturation in latinos. Journal of Transcultural Nursing, 24(2), 134–143. Scholar
  4. Arandia, G., Nalty, C., Sharkey, J. R., & Dean, W. R. (2012). Diet and acculturation among Hispanic/Latino older adults in the United States: A review of literature and recommendations. Journal of Nutrition in Gerontology and Geriatrics, 31(1), 16–37. Scholar
  5. Balcazar, H., Trier, C. M., & Cobas, J. A. (1995). What predicts breastfeeding intention in Mexican-American and non-Hispanic white women? Evidence from a national survey. Birth (Berkeley, Calif.), 22(2), 74–80.CrossRefGoogle Scholar
  6. Barcelona de Mendoza, V., Harville, E., Theall, K., Buekens, P., & Chasan-Taber, L. (2016). Acculturation and intention to breastfeed among a population of predominantly Puerto Rican women. Birth (Berkeley, Calif.), 43(1), 78–85. Scholar
  7. Berry, J. W. (2003). Conceptual approaches to acculturation. In K. M. Chun, P. B. Organista & G. Marin (Eds.), Acculturation: Advances in theory, measurement and applied research. Washington, DC: American Psychological Association.Google Scholar
  8. Bown, M. J., & Sutton, A. J. (2010). Quality control in systematic reviews and meta-analyses. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 40(5), 669–677. Scholar
  9. Byrd, T. L., Balcazar, H., & Hummer, R. A. (2001). Acculturation and breast-feeding intention and practice in Hispanic women on the US-Mexico border. Ethnicity & Disease, 11(1), 72–79.Google Scholar
  10. Centers for Disease Control and Prevention. (2014). Breastfeeding rates. Retrieved from:
  11. Chakraborty, B. M., & Chakraborty, R. (2010). Concept, measurement and use of acculturation in health and disease risk studies. Collegium Antropologicum, 34(4), 1179–1191.PubMedGoogle Scholar
  12. Chapman, D. J., & Perez-Escamilla, R. (2013). Acculturative type is associated with breastfeeding duration among low-income Latinas. Maternal & Child Nutrition, 9(2), 188–198. Scholar
  13. Flores, A., Anchondo, I., Huang, C., Villanos, M., & Finch, C. (2016). “Las dos cosas” or why Mexican American mothers breast-feed, but not for long. Southern Medical Journal, 109(1), 42–50. Scholar
  14. Gibson, M. V., Diaz, V. A., Mainous, A. G. 3rd, & Geesey, M. E. (2005). Prevalence of breastfeeding and acculturation in Hispanics: Results from NHANES 1999–2000 study. Birth (Berkeley. Calif.), 32(2), 93–98.CrossRefGoogle Scholar
  15. Gibson-Davis, C. M., & Brooks-Gunn, J. (2006). Couples’ immigration status and ethnicity as determinants of breastfeeding. American Journal of Public Health, 96(4), 641–646.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Glassman, M. E., McKearney, K., Saslaw, M., & Sirota, D. R. (2014). Impact of breastfeeding self-efficacy and sociocultural factors on early breastfeeding in an urban, predominantly Dominican community. Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine, 9(6), 301–307. Scholar
  17. Gonzalez de Cosio, T., Escobar-Zaragoza, L., Gonzalez-Castell, L. D., & Rivera-Dommarco, J. A. (2013). [Infant feeding practices and deterioration of breastfeeding in Mexico]. Salud Publica Mex, 55(Suppl 2), S170–S179.Google Scholar
  18. Gorman, J. R., Madlensky, L., Jackson, D. J., Ganiats, T. G., & Boies, E. (2007). Early postpartum breastfeeding and acculturation among Hispanic women. Birth (Berkeley, Calif.), 34(4), 308–315.CrossRefGoogle Scholar
  19. Harley, K., Stamm, N. L., & Eskenazi, B. (2007). The effect of time in the U.S. on the duration of breastfeeding in women of Mexican descent. Maternal and Child Health Journal, 11(2), 119–125. Scholar
  20. Hawkins, S. S., Gillman, M. W., Shafer, E. F., & Cohen, B. B. (2014). Acculturation and maternal health behaviors: Findings from the Massachusetts birth certificate. American Journal of Preventive Medicine, 47(2), 150–159. Scholar
  21. Hendrick, C. E., & Potter, J. E. (2017). Nativity, country of education, and mexican-origin women's breastfeeding behaviors in the first 10 months postpartum. Birth, 44(1), 68–77. Scholar
  22. Hendrix, I. C. (2004). RefWorks. Journal of the Medical Library Association, 92(1), 111–113.PubMedCentralGoogle Scholar
  23. Kimbro, R. T., Lynch, S. M., & McLanahan, S. (2008). The influence of acculturation on breastfeeding initiation and duration for Mexican-Americans. Population Research and Policy Review, 27(2), 183–199. Scholar
  24. Lara, M., Gamboa, C., Kahramanian, M. I., Morales, L. S., & Bautista, D. E. (2005). Acculturation and Latino health in the United States: A review of the literature and its sociopolitical context. Annual Review of Public Health, 26, 367–397. Scholar
  25. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P., … Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ (Clinical Research Ed.), 339, b2700. Scholar
  26. Lizarraga, J. L., Maehr, J. C., Wingard, D. L., & Felice, M. E. (1992). Psychosocial and economic factors associated with infant feeding intentions of adolescent mothers. Journal of Adolescent Health, 13(8), 676–681.CrossRefPubMedGoogle Scholar
  27. Luecken, L. J., Jewell, S. L., & MacKinnon, D. P. (2017). Maternal acculturation and the growth of impoverished Mexican American infants. Obesity, 25(2), 445–451.CrossRefPubMedGoogle Scholar
  28. Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., & Petticrew, M. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4, 1-4053-4-1. Scholar
  29. Office of the Surgeon General (US); Centers for Disease Control and Prevention (US); Office on Women’s Health (US). The Surgeon General’s Call to Action to Support Breastfeeding. Rockville (MD): Office of the Surgeon General (US). (2011). Barriers to breastfeeding in the United States. Retrieved from
  30. Rassin, D. K., Markides, K. S., Baranowski, T., Bee, D. E., Richardson, C. J., Mikrut, W. D., & Winkler, B. A. (1993). Acculturation and breastfeeding on the United States-Mexico border. The American Journal of the Medical Sciences, 306(1), 28–34.CrossRefPubMedGoogle Scholar
  31. Rassin, D. K., Markides, K. S., Baranowski, T., Richardson, C. J., Mikrut, W. D., & Bee, D. E. (1994). Acculturation and the initiation of breastfeeding. Journal of Clinical Epidemiology, 47(7), 739–746.CrossRefPubMedGoogle Scholar
  32. Singh, G. K., Kogan, M. D., & Dee, D. L. (2007). Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003. Pediatrics, 119(Suppl 1), S38–S46.CrossRefPubMedGoogle Scholar
  33. Sussner, K. M., Lindsay, A. C., & Peterson, K. E. (2008). The influence of acculturation on breast-feeding initiation and duration in low-income women in the US. Journal of Biosocial Science, 40(5), 673–696.CrossRefPubMedGoogle Scholar
  34. Thiel de Bocanegra, H. (1998). Breast-feeding in immigrant women: The role of social support and acculturation. Hispanic Journal of Behavioral Sciences., 20(4), 448–467. Scholar
  35. Thomas, B. H., Ciliska, D., Dobbins, M., & Micucci, S. (2004). A process for systematically reviewing the literature: Providing the research evidence for public health nursing interventions. Worldviews on Evidence-Based Nursing, 1(3), 176–184.CrossRefPubMedGoogle Scholar
  36. World Health Organization. (2008). Indicators for assessing infant and young child feeding practices. Retrieved from
  37. World Health Organization. (2011). Exclusive breastfeeding for six months best for babies everywhere. Retrieved from

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Epidemiology, Human Genetics and Environmental Sciences, School of Public Health – Austin Regional CampusThe University of Texas Health Science Center at HoustonAustinUSA
  2. 2.Biostatistics and Data Science, School of Public Health – Austin Regional CampusThe University of Texas Health Science Center at HoustonAustinUSA
  3. 3.Management Policy and Community Health, School of Public HealthUniversity of TexasEl PasoUSA

Personalised recommendations