Factors Associated with Exclusive Breastfeeding in the US- My Review

Published December, 2011 in PEDIATRICS Volume 128

Jones, Kogan, Singh, Dee, Grummer-Strawn

This study was trying to determine what factors were causing the duration of breastfeeding to remain low in the US. It was sad to see that in the 75% of the children breastfed only a little more than 16% were breastfed exclusively for six months. Race showed little difference in the exclusivity of breastmilk in the first six months but race did have a difference in the non Hispanic black children who were breastfed less. Government agencies and medical organizations promote breastfeeding- and it does seem to have made a difference.  Since the value of breastfeeding exclusively is thought to make a difference in reduction of medical cost of 2.2 million dollars per year, it is in the government’s interest to promote it. They hope to change the percentage that was found in 2006 of just over 14% exclusively fed for six months to a little over 25% and hope to increase breastfeeding being initiated to over 80%.

The factors that were considered associated with breastfeeding being exclusive for six months included: race, income, density of residence, mom’s age, education, marital status and BMI.  They knew of no study that took into consideration the mom’s emotional or mental health, whether she was native or immigrant, if there was a smoker in the home or the family structure. They interviewed over 91 thousand families targeting only one child and the children being between 6 months and five years of age.

Exclusive breastfeeding was determined to be done for 180 days with nothing else- no other food or liquid offered including water. The study wanted to look at these factors: mother’s age at time of birth, education level, immigrant/nativity status, mental/emotional health, race, birth weight of the baby, family structure, poverty status, and tobacco use in the household and density of residence.

What they found for initiating breastfeeding factors were the moms who were over the age of 30- although the difference between the age of 21- 29 was only slightly lower- but young moms had the lowest rate, had a higher level of education- more than high school, were born outside of the US, and had excellent mental health- although very good mental health also fared well, was Hispanic or non Hispanic white or non Hispanic mixed race, had a low birth weight less than 1500 grams-  which is 3.3 pounds, the child was living with two biological or adoptive parents, had a higher income with no one smoking and lived in a metropolitan area.

What they found for exclusively breastfeeding for six month many factors were the same in many areas although ethnicity had less influence although Hispanic moms did best, and the larger the baby at birth factored in- leaving me to believe that moms are encouraged to pump and feed their premature babies well in the hospital but after discharge are not continuing to do so exclusively, but the other factors held true to the initiating moms. The moms with better mental health did seem to nurse exclusively more often than the moms with mental or emotional health that was less. Age was certainly the factor for exclusivity though- as younger moms were less likely to breastfeed exclusively.

The thought is that black women still move toward formula feeding for a variety of reasons- one being it is seen as acceptable to that population more so than others. But exclusivity if it was initiated was not significantly different than the white population.