Racial and Ethnic Differences in Reasons for Breastfeeding Cessation Among Women Participating in the Special Supplemental Nutrition Program for Women, Infants, and Children

Abstract

Introduction Breastfeeding rates among women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower compared with those of nonparticipants. The objective of this study was to assess racial and ethnic differences in self‐reported reasons for breastfeeding cessation during the first year postpartum. Methods This was a secondary analysis of data from women participating in the WIC Infant and Toddler Feeding Practices Study‐2. Women specified reasons that influenced their decision to stop breastfeeding during telephone interviews between 1 and 13 months postpartum. Logistic regression models for each racial and ethnic group explored the effects of sociodemographic variables on each reason. Results The sample for this analysis included 4095 women (34.1% non‐Hispanic white, 25.5% non‐Hispanic black, and 40.4% Hispanic). Across all race and ethnic groups, food security status was a predictor of some but not all reasons for breastfeeding cessation. Compared with their counterparts who were food secure, white women with low food security and black women with very low food security were more likely (odds ratio [OR], 1.86; 95% CI, 1.04‐3.35 and OR, 1.86; 95% CI, 1.19‐2.90, respectively) to stop breastfeeding because they wanted or needed someone else to feed their infants. Hispanic women with very low food security were more likely to stop breastfeeding because they felt they did not have enough milk. Compared with their multiparous counterparts, primiparous black and white women were almost twice as likely to stop breastfeeding because of trouble sucking or latching. Hispanic and black women born outside the United States had significantly higher odds of breastfeeding cessation because of the infant losing interest compared with US‐born women. Education and marital status significantly predicted reasons for breastfeeding cessation among Hispanic and white women. Discussion Among women participating in WIC, food security, parity, country of birth, education, and marital status were significant predictors of reasons for breastfeeding cessation across racial and /ethnic groups. Incorporating these findings in education, counseling, and interventions may help overcome breastfeeding barriers.

Association of Maternal Confidence and Breastfeeding Practices in Hispanic Women Compared to Non-Hispanic White Women

“…The decision to compare Hispanic and non-Hispanic White women was made as prior work has demonstrated stark differences in breastfeeding initiation and duration by race and ethnicity. 17 , 18 Multinomial logistic regression analysis was performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for association of the frequency of breastmilk feeds and the maternal confidence score at 6 and 12 months adjusting for gestational age. The association of the frequency of breastmilk feeds and the maternal confidence score was examined at 6 and 12 months stratified by ethnicity.…”

Maternal Worry About Infant Weight and its Influence on Artificial Milk Supplementation and Breastfeeding Cessation

“…Finally, in a large secondary analysis ( N = 4095), researchers examined participants’ reasons for breastfeeding cessation during the 1st year. Although data regarding maternal worry about infant weight was collected in the primary study, it was not included in the secondary analysis or study findings (Gallo et al, 2019).…”

Symptoms of problematic feeding in infants under 1 year of age undergoing frenotomy: A review article

“…The reasons for breastfeeding cessation are complex and multidimensional. Socioeconomic factors, employment status, competing family demands, food insecurity, breastfeeding discomfort and concerns surrounding infant weight gain and nutrition are all contributing factors that lead to early breastfeeding cessation 11‐13 …”

“…Socioeconomic factors, employment status, competing family demands, food insecurity, breastfeeding discomfort and concerns surrounding infant weight gain and nutrition are all contributing factors that lead to early breastfeeding cessation. [11][12][13] There are many factors that lead to early cessation of EBF, with one of the most commonly reported reasons being nipple pain. 14 Tongue tie has been associated with nipple pain, 15 and frenotomy to treat tongue tie is thought to reduce breastfeeding issues.…”