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Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation

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Abstract

Objectives This study examines the associations between specific maternity care practices and breastfeeding duration for Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White women. Methods We analyzed data from the 2012–2014 New Mexico Pregnancy Risk Assessment Monitoring System. We used survey language as a proxy measure of acculturation and categorized women as Spanish-speaking Hispanic, English-speaking Hispanic, non-Hispanic Native American, and non-Hispanic White. We conducted bivariate analyses to compare rates of breastfeeding at 2 months and experiences of maternity care practices and logistic regression analysis to estimate the effects of these practices on breastfeeding duration for each group. Results Hispanic women were less likely than non-Hispanic women to breastfeed for at least 2 months (67.9% vs. 76.6%; p = 0.000); however, this varied significantly by acculturation level: 78.1% of Spanish-speaking Hispanic women compared to 66.1% of English-speaking Hispanic women breastfed for at least 2 months (p = 0.000). The effects of specific maternity care practices on duration varied across groups. Among non-Hispanic White, Native American, and English-speaking Hispanic women, breastfeeding while at the hospital had the strongest effect (AOR 2.09, 95% CI 1.67–2.61; AOR 2.71, 95% CI 2.08–3.52; and AOR 1.99, 95% CI 1.76–2.25, respectively). Among Spanish-speaking Hispanic women, being encouraged to breastfeed on demand had the strongest effect (AOR 5.179, 95% CI 3.86–6.94). Conclusions for Practice The effects of maternity care practices on breastfeeding duration vary by race, ethnicity, and acculturation level. Health care systems must acknowledge the diversity of their patient populations when seeking to develop and implement breastfeeding-friendly practices.

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Acknowledgements

The study was supported by W.K. Kellogg Foundation (Grant No. P3034276) and New Mexico Human Services Department (Grant No. 14-630-8000-0008 A2).

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Authors and Affiliations

  1. Child Policy Research Consulting, LLC, 124 Basswood Circle, Fort Wright, KY, 41011, USA

    Rachel A. Sebastian

  2. New Mexico Department of Health, 1190 S. St. Francis Drive, Santa Fe, NM, 87505, USA

    Eirian Coronado

  3. Nuestra Salud, LLC, 4282 Alexander Blvd NE, Albuquerque, NM, 87107, USA

    Maria D. Otero

  4. Department of Pediatrics, University of New Mexico School of Medicine, 625 Silver Avenue SW, Suite 324, Albuquerque, NM, 87102, USA

    Courtney R. McKinney

  5. Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico School of Medicine, MSC 10 5590, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA

    Mary M. Ramos

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  1. Rachel A. Sebastian
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  2. Eirian Coronado
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  3. Maria D. Otero
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  4. Courtney R. McKinney
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Correspondence to Rachel A. Sebastian.

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Sebastian, R.A., Coronado, E., Otero, M.D. et al. Associations Between Maternity Care Practices and 2-Month Breastfeeding Duration Vary by Race, Ethnicity, and Acculturation. Matern Child Health J 23, 858–867 (2019). https://doi.org/10.1007/s10995-018-02711-2

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