The Decision to Breastfeed in the United States: Does Race Matter?

Forste, Renata; Weiss, Jessica; Lippincott, Emily

doi:10.1542/peds.108.2.291

Cited by 171 publications

(156 citation statements)

References 26 publications

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“…7,47 In addition, our proxy for SES was the higher of either maternal or paternal education, rather than maternal education only. Studies have shown that maternal education is an important factor in the decision to breastfeed, 27,28,32,48 although highest household and paternal education are often independent predictors as well. 26,[49][50][51] Because previous research demonstrated that our primary outcome, BMI, is associated with parental education regardless of the parent considered, 52 we used highest parental education in this study.…”

Section: Discussionmentioning

confidence: 99%

“…17,[22][23][24][25] These inconsistencies may reflect the correlation of racial/ethnic minority status with low SES, as well as racial and SES differences in breastfeeding behavior. [26][27][28] Despite these controversies, to date, the literature suggests that breastfeeding has a small but consistent independent protective effect on adiposity, adjusting for underlying racial or SES differences in adiposity. 29 However, to our knowledge, no studies have explored the role that breastfeeding may play in the development of racial/ethnic and SES disparities in overweight, including the possibility that breastfeeding may lie in the pathway between social disadvantage and increased adiposity.…”

Section: Introductionmentioning

confidence: 99%

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Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity

et al. 2008

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OBJECTIVES-Studies suggest that breastfeeding is protective for later obesity; however, this association has not held among all racial and socioeconomic status groups. Racial and socioeconomic status differences in breastfeeding behavior have also been noted. In this study, we formally test whether breastfeeding mediates the relationship between race and socioeconomic status with adolescent adiposity.METHODS-Data were analyzed from 739 black and white 10-to 19-year-old adolescents who participated in a large, school-based study. Parents provided information on parental education, used to measure socioeconomic status, and whether the child was breastfed as an infant. BMI was used to measure adolescent adiposity and was analyzed as a continuous measure (BMI z score) using linear regression and categorically (BMI ≥85th and ≥95th percentile) using logistic regression.RESULTS-Black adolescents and those without a college-educated parent were less likely to have been breastfed for >4 months. Race and parental education were each independent predictors of BMI z score and of having BMI ≥85th percentile or BMI ≥95th percentile. When added to the model, being breastfed for >4 months was also independently associated with lower BMI z score and lower odds of having BMI ≥85th percentile or BMI ≥95th percentile. Inclusion of being breastfed for >4 months resulted in a 25% decrease in racial and parental education differences in adolescent BMI z score, supporting partial mediation.CONCLUSIONS-Having been breastfed for >4 months was associated with lower adolescent BMI z score and lower odds of having a BMI ≥85th percentile or BMI ≥95th percentile, independent of race or parental education. Furthermore, these analyses suggest that being breastfed for >4 months partially explains the relationship between social disadvantage and increased adiposity. Increasing breastfeeding duration could result in lower adolescent adiposity for all racial and socioeconomic status groups and potentially minimize socioeconomic disparities in adiposity.Keywords adolescent obesity; breastfeeding; epidemiology; racial differences; socioeconomic status Copyright © 2008 Adolescent obesity is a major public health issue that has been increasing in the past 2 decades. This problem disproportionately affects socially disadvantaged groups. Recent national studies have found that >40% of black adolescents aged 12 to 19 are at risk for overweight (eg, BMI ≥85th percentile for age and gender) or are overweight (BMI ≥95th percentile) compared with 26.5% of white teens and that this proportion has been increasing. 1,2 In addition, low socioeconomic status (SES) is frequently associated with higher rates of overweight. [3][4][5][6] Thus, the search for causes and potential interventions to decrease these disparities and reduce the prevalence of overweight is crucial.Breastfeeding has been reported as being protective against obesity, but this association is somewhat controversial. Whereas several studies found significantly lower obesity rates among th...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity

et al. 2008

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“…Many women may experience difficulties with breastfeeding because of poor education about the practice, and, in a few instances, genuine physical problems (Hannon et al 2000;Maclean 1988;Schmied and Lupton 2001). In one study, 83% of black women said that they preferred to formulafeed (Forste, Weiss and Lippincott 2001). Because Mexican immigrants often live in low SES neighborhoods with or near African-Americans, one might expect the preference for bottle-feeding to transfer from one culture to another.…”

Section: The Theory Of Acculturationmentioning

confidence: 99%

The Influence of Acculturation on Breastfeeding Initiation and Duration for Mexican-Americans

Kimbro

Lynch

McLanahan

2007

Popul Res Policy Rev

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This paper uses data from the Fragile Families and Child Wellbeing Study to test the hypotheses that (1) Similar to other positive pre-and post-natal outcomes, Mexican immigrant mothers are more likely to breastfeed, and to breastfeed longer, than white or Mexican-American mothers; and (2) Acculturation accounts for the ethnic/nativity differential in breastfeeding initiation and duration. The results support both hypotheses. Mexican immigrants to the U.S. are much more likely than whites to breastfeed, and to breastfeed longer. Mexican-American mothers, after controlling for background characteristics, have similar initiation and duration to whites. Using expanded acculturation measures developed for this paper, acculturation accounts for some of the difference between whites and Mexican immigrants in breastfeeding initiation, and much of the difference for breastfeeding duration. The results suggest that low levels of acculturation operate to protect Mexican immigrants from choosing to formula-feed, which gives their babies many health advantages, and may be associated with better health outcomes across the life course. The results also suggest that successive generations of Mexican immigrants may abandon breastfeeding, which is deleterious for their infants.

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“…The respective percentages breastfeeding at 6 months were 44.4 and 30.1 % [5]. Such disparities reflect, in part, racial differences in socioeconomic, employment, and marital status; however, racial disparities still persist even after controls for such explanations are accounted for [6][7][8][9][10]. AsianAmerican and Latina breastfeeding initiation rates and duration, on the other hand, tend to be highest of all ethnic groups [27].…”

Section: Introductionmentioning

confidence: 99%

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

Lundquist

Barfield³

et al. 2014

Matern Child Health J

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We conduct a comparative analysis of breastfeeding behavior between military and civilian-affiliated mothers. Our focus is on African American mothers among whom breastfeeding rates are lowest. The military context may mitigate conditions associated with low breastfeeding prevalence by (a) providing stable employment and educational opportunities to populations who face an otherwise poor labor market and (b) providing universal healthcare that includes breastfeeding consultation. Using pregnancy risk assessment monitoring system (PRAMS) data for which we received special permission from each state to flag military affiliation, we analyze civilians and military affiliate in breastfeeding initiation using logistic regression and breastfeeding duration using Cox proportional hazard analysis. We find that breastfeeding is more prevalent among all women in the military setting and that the blackwhite gap in breastfeeding duration common among civilians is significantly reduced among military affiliates. Breastfeeding is a crucial component of maternal and child health and eliminating racial disparities in its prevalence is a public health priority. This study is the first to identify the military as an important institutional context that deserves closer examination to glean potential policy implications for civilian society.

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The Decision to Breastfeed in the United States: Does Race Matter?

Abstract: Race is an important predictor of breastfeeding, with most black women reporting that they "preferred bottle-feeding." Efforts to increase breastfeeding of infants in the black community should help narrow the racial gap in infant mortality.

Cited by 171 publications

References 26 publications

Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity

Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity

The Influence of Acculturation on Breastfeeding Initiation and Duration for Mexican-Americans

Do Black–White Racial Disparities in Breastfeeding Persist in the Military Community?

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