Local Disparities in Breastfeeding Initiation and Duration: A Cross-Sectional Population-Based Survey in Ten Chicago Community Areas
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Breastfeeding confers substantial health benefits to women and infants. While disparities in breastfeeding persist in the United States, the extent of these disparities at the local level is unclear. This study aimed to identify local level and racial/ethnic breastfeeding disparities within Chicago. A community-based representative survey including questions on breastfeeding was conducted in Chicago. We estimated the proportion of women who breastfed their last child for any length of time and who breastfed at 6 months by neighborhood and maternal characteristics. We performed Rao-Scott corrected chi-squared tests to analyze factors hypothesized to be associated with breastfeeding. Between March 2015 and September 2016, 641 women with at least one live birth completed the survey. We found no differences by community area in the breastfeeding initiation or breastfeeding for at least 6 months. Puerto Rican women had the lowest prevalence of breastfeeding initiation and continuation at 6 months in contrast to Mexican women who reported the highest prevalence of these practices. We found breastfeeding disparities between Puerto Rican and Mexican Hispanic subgroups. Policies and programs aimed at increasing breastfeeding should prioritize groups that are least likely to initiate breastfeeding or most likely to breastfeed for a limited duration.
KeywordsBreastfeeding Epidemiology Disparities Race/ethnicity Survey
This work was supported by the Chicago Community Trust (Grant Numbers C2013-00630, C2014-01723, C2015-04294).
Compliance with Ethical Standards
Conflict of interest
The authors have no conflicts of interest to declare.
- 2.Centers for Disease Control and Prevention. (2014). Breastfeeding Report CardGoogle Scholar
- 3.Office of Disease Prevention and Health Promotion. (2013). Healthy People 2020. U.S. Department of Health and Human Services, Washington, D.C. 2013. https://www.healthypeople.gov/. Accessed May 30, 2017.
- 7.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, 28(2), 167–173. https://doi.org/10.1177/0890334412438403.CrossRefPubMedGoogle Scholar
- 9.Hirschtick, J. L., Benjamins, M. R., & Homan, S. (2017). Community health counts: Sinai Community Health Survey 2.0. Chicago, IL: Sinai Urban Health Institute, Sinai Health System 2017.Google Scholar
- 10.American Association for Public Opinion Research. (2016). Standard definitions: Final dispositions of case codes and outcome rates for surveys.Google Scholar
- 11.Coronado, G. D., Thompson, B., McLerran, D., Schwartz, S. M., & Koepsell, T. D. (2005). A short acculturation scale for Mexican-American populations. Ethnicity & Disease, 15(1), 53–62.Google Scholar
- 13.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, 20(1), 39–45. https://doi.org/10.1177/0890334403261129.CrossRefPubMedGoogle Scholar
- 17.Chicago Department of Public Health. (2017). Breastfeeding in Chicago: PRAMS 2010–2012. https://www.healthychicagobabies.org/wp-content/uploads/2017/08/HCB-data-breastfeeding-d9ed1011d790f655c3050961a0db3e87.pdf.
- 19.Illinois Department of Public Health. Illinois Hospital Report Card and Consumer Guide to Health Care: Maternal/Child - Breastfeeding. Illinois Department of Public Health. (2015). http://www.healthcarereportcard.illinois.gov/. Accessed April 18 2017.
- 20.Chicago Department of Public Health. (2012). Breastfeeding and the Baby-Friendly Hospital Initiative. https://d14abeop4cfxkt.cloudfront.net/cms/files/63/files/original/BabyFriendlyHospital32012.pdf.
- 21.Baby-Friendly, U. S. A. (2017). Designated facilities. Baby-friendly USA. https://www.babyfriendlyusa.org/find-facilities/designated-facilities--by-state. Accessed May 5 2017.
- 26.Chicago Department of Public Health. (2016). Healthy Chicago 2.0: Partnering to Improve Health Equity. https://www.cityofchicago.org/content/dam/city/depts/cdph/CDPH/HC2.0Plan_3252016.pdf.
- 28.Centers for Disease Control and Prevention. (2013). Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to support breastfeeding mothers and babies. U.S. Department of Health and Human Services, Atlanta. https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf.
- 29.Evans, K., Labbok, M., & Abrahams, S. W. (2011). WIC and breastfeeding support services: does the mix of services offered vary with race and ethnicity? Breastfeeding Medicine: The Official Journal of the Academy of Breastfeeding Medicine, 6(6), 401–406. https://doi.org/10.1089/bfm.2010.0086.CrossRefGoogle Scholar
- 30.U.S. Department of Agriculture. Women, Infants and Children (WIC): Breastfeeding Is a Priority in the WIC Program. 2018. https://www.fns.usda.gov/wic/breastfeeding-priority-wic-program. Accessed February 8, 2018.