Familial sources of encouragement and breast-feeding practices among women participating in the US Special Supplemental Nutrition Programme for Women, Infants and Children

Abstract

Objective: To explore how sources of familial encouragement are associated with breastfeeding initiation and duration among a national sample participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: This study uses the 2013-2015 WIC Infant and Toddler Feeding Practices Study 2 (WIC ITFPS-2) data. Breastfeeding initiation was measured at the first month while duration was derived from a composite of the first 13 months. The analysis used logistic and linear regression to explore the association between encouragement sources and breastfeeding outcomes. Setting: A nationally representative sample of WIC participants in the United States. Participants: WIC participants who completed the 13-month interview of the WIC ITFPS-2 (n=2,807). Results: Encouragement was significantly associated with both initiation and duration. Each source of encouragement was associated with a 3.2 (95% CI 2.8-3.8) increase in odds of initiating breastfeeding in the unadjusted model and 3.0 (95% CI 2.5-3.6) increased odds, controlling for age, education, nativity, poverty status, race, and ethnicity (<0.0001). When predicting log duration, each percent increase in source of encouragement was associated with an increasing duration on average by 0.003 days (95% CI 0.2-0.3, <0.0001). When controls were added, it was associated with an increase of an average of 0.002 days (95% CI 0.2-0.3) days per percent increase in encouragement source (<0.0001). Conclusions: Women who receive encouragement appear to be more likely to breastfeed. Additional work is needed to explore sources of encouragement and how to include them in intervention work.