Racial Differences in Breastfeeding Initiation among Participants in a Midwestern Public Health District

Purpose: Although variations in breastfeeding initiation are well documented, the contributing role of maternal race remains poorly understood, especially among the multiracial - two or more races - population. The purpose of this study is to examine differences in breastfeeding initiation among a racially and ethnically diverse population of low-income women. Methods: Participants for this study (n=1010) were enrolled in the supplemental nutrition program for women, infant, and children and concurrently enrolled in a perinatal depression registry at a public health clinic in the Midwest. Race was obtained from medical records. Breastfeeding initiation was gathered through a clinical interview during the first postpartum visit. Logistic regression was conducted using STATA 14.2. Results: Sixty-eight percent of study participants reported breastfeeding initiation. The bivariate analysis demonstrated that there were significant differences in rates of breastfeeding initiation by race/ethnicity. The logistic regression models showed that after adjusting for maternal education, age, income, nativity, parity, body mass index, and antenatal smoking, Black (odds ratio [OR] 0.47; confidence interval [95% CI] 0.34-0.66), multiracial (OR 0.21; 95% CI 0.07-0.65), and Latina women (OR 0.48; 95% CI 0.26-0.86) were significantly less likely to initiate breastfeeding compared with White women. Conclusion: These findings highlight the need for further understanding of the underlying barriers to the initiation of breastfeeding among low-income Black, multiracial, and Latina women. Moreover, breastfeeding should remain a priority for intervention and policy development, particularly among racially and ethnically diverse low-income women.