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

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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References

  1. AAP. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e826–e841.

    Article  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. Ahluwalia, I. B., Morrow, B., D’Angelo, D., & Li, R. (2012). Maternity care practices and breastfeeding experiences of women in different racial and ethnic groups: Pregnancy Risk Assessment and Monitoring System (PRAMS). Maternal and Child Health Journal, 16, 1672–1678.

    Article  PubMed  Google Scholar 

  4. Anstey, E. H., Chen, J., Elam-Evans, L. D., & Perrine, C. G. (2017). Racial and geographic differences in breastfeedingUnited States, 2011–2015. Retrieved November 14, 2017 from https://www.cdc.gov/mmwr/volumes/66/wr/mm6627a3.htm.

  5. CDC. (2017). CDC National Immunization Survey: Breastfeeding among US children born 2002–2013. Retrieved May 3, 2017 from http://www.cdc.gov/breastfeeding/data/nis_data/index.htm.

  6. CDC PRAMS. Retrieved November 14, 2017 from https://www.cdc.gov/prams/.

  7. Chantry, C. J., Dewey, K. G., Peerson, J. M., Wagner, E. A., & Nommsen-Rivers, L. A. (2014). In-hospital formula use increases early breastfeeding Cessation among first-time mothers intending to exclusively breastfeed. Journal of Pediatrics, 164(6), 1339–1345.

    Article  PubMed  Google Scholar 

  8. Chapman, D. J., & Perez-Escamilla, R. (2013). Acculturative type is associated with breastfeeding duration among low-income Latinas. Maternal and Child Nutrition, 9, 188–198.

    Article  PubMed  Google Scholar 

  9. Gibson, M. V., Diaz, V. A., Mainous, A. G., & Geesey, M. E. (2005). Prevalence of breastfeeding and acculturation in Hispanics: Results from NHANES 1999–2000 study. Birth, 32(2), 93–98.

    Article  PubMed  Google Scholar 

  10. Gill, S. L. (2009). Breastfeeding by Hispanic women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(2), 244–252.

    Article  Google Scholar 

  11. Gorman, J. R., Madlensky, L., Jackson, D. J., Ganiats, T. G., & Boies, E. (2007). Early postpartum breastfeeding and acculturation among Hispanic women. Birth, 34(4), 308–315.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Healthy People 2020. Maternal, infant, and child health objectives. Retrieved September 21, 2017 from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

  15. Henninger, M. L., Irving, S. A., Kauffman, T. L., Kurosky, S. K., Rompala, K., Thompson, M. G., … Naleway, A. L. (2017). Predictors of breastfeeding initiation and maintenance in an Integrated Healthcare setting. Journal of Human Lactation, 33(2), 256–266.

    Article  PubMed  Google Scholar 

  16. IBM Corp. (2015). IBM SPSS statistics for Windows (Version 23.0). Armonk: IBM Corp.

    Google Scholar 

  17. Ip, S., Chung, M., Ramen, G., Chew, P., Magula, N., DeVine, D., … Lau, J. (2007). Breastfeeding and maternal and child health outcomes in developed countries. Rockville, MD: Agency for Healthcare Research and Quality.

    Google Scholar 

  18. Jones, J. R., Kogan, M. D., Singh, G. K., Dee, D. L., & Grummer-Strawn, L. M. (2011). Factors associated with exclusive breastfeeding in the United States. Pediatrics, 128(6), 1117–1125.

    Article  PubMed  Google Scholar 

  19. Li, R., Darling, N., Maurice, E., Barker, L., & Grummer-Strawn, L. M. (2005). Breastfeeding rates in the United States by characteristics of the child, mother, or family: The 2002 National Immunization Survey. Pediatrics, 115(1), e31–e37.

    PubMed  Google Scholar 

  20. Lind, J. N., Perrine, C. G., Li, R., Scanlon, K. S., & Grummer-Strawn, L. M. (2014). Racial disparities in access to maternity care practices that support breastfeedingUnited States, 2011. Retrieved October 12, 2017 from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6333a2.htm.

  21. 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, 138(2), 1–11.

    Article  Google Scholar 

  22. Merewood, A., Brooks, D., Bauchner, H., MacAuley, L., & Mehta, S. D. (2006). Maternal birthplace and breastfeeding initiation among term and preterm infants: A statewide assessment for Massachusetts. Pediatrics, 118(4), e1048–e1054.

    Article  PubMed  Google Scholar 

  23. New Mexico PRAMS. Retrieved November 14, 2017 from https://nmhealth.org/about/phd/fhb/prams.

  24. Petrova, A., Hegyi, T., & Mehta, R. (2007). Maternal race/ethnicity and one-month exclusive breastfeeding in association with in-hospital feeding modality. Breastfeeding Medicine, 2(2), 92–98.

    Article  PubMed  Google Scholar 

  25. 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(Supplement 1), S38–S46.

    Article  PubMed  Google Scholar 

  26. Sparks, P. J. (2011). Racial/ethnic differences in breastfeeding duration among WIC-eligible families. Women’s Health Issues, 21(5), 374–382.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  PubMed  Google Scholar 

  28. Sutherland, T., Pierce, C. B., Blomquist, J. L., & Handa, V. L. (2012). Breastfeeding practices among first-time mothers and across multiple pregnancies. Maternal and Child Health Journal, 16(8), 1665–1671.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Wambach, K., Domian, E. W., Page-Goertz, S., Wurtz, H., & Hoffman, K. (2016). Exclusive breastfeeding experiences among Mexican American women. Journal of Human Lactation, 32(1), 103–111.

    Article  PubMed  Google Scholar 

  30. WHO/UNICEF. (1989). Protecting, promoting, and supporting breastfeeding: The special role of maternity services. Geneva: World Health Organization.

    Google Scholar 

  31. WHO/UNICEF. (1998). Evidence for the ten steps to successful breastfeeding. Geneva: World Health Organization.

    Google Scholar 

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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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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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Keywords

  • Breastfeeding duration
  • Race and ethnicity
  • Acculturation
  • Maternity care practices
  • Baby-Friendly Hospital Initiative