Couples’ Immigration Status and Ethnicity as Determinants of Breastfeeding

Teachers College, Columbia University, New York, New York, United States
American Journal of Public Health (Impact Factor: 4.55). 05/2006; 96(4):641-6. DOI: 10.2105/AJPH.2005.064840
Source: PubMed


We investigated how couples' immigration status and ethnicity determined the decision to initiate breastfeeding and to breastfeed at 6 months.
From data collected on 4207 mothers and 3013 fathers participating in a longitudinal birth cohort study, we used linear regression and covariate-adjusted proportions to estimate the determinants of breastfeeding behaviors. The sample was divided by immigration status (either foreign born or born in the United States) and further subdivided by ethnicity (Mexican Hispanic, non-Mexican Hispanic, and non-Hispanic).
Mothers born in the United States had an 85% reduction in the odds of breastfeeding as compared to foreign-born mothers and a 66% reduction in the odds of breastfeeding at 6 months. Each additional year of US residency decreased the odds of breastfeeding by 4%. These differences by immigration status were seen for Mexicans, other Hispanics, and non-Hispanics.
The Hispanic paradox may extend to other non-Hispanic immigrants for breastfeeding behaviors, but may not be true for Hispanic mothers born in the United States. Low rates of breastfeeding for Hispanic American mothers indicate that they should not be overlooked by breastfeeding promotion programs.

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    • "Among adult mothers nationally, racial-ethnic patterns are similar, but differences are less pronounced [1]. The exceptionally high breastfeeding rates among Hispanic teens in our study may relate to the fact that nearly 60% of Hispanics in North Carolina are immigrants [14], and less-acculturated immigrants have higher breastfeeding initiation rates and breastfeed for longer durations than U.S.-born women [15,16]. "
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    ABSTRACT: Adolescent mothers in the U.S. are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger. Quantitative descriptive analyses are conducted using data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The population-based sample comprises 389 teens ages 13-17 giving birth to a live born infant in North Carolina in 2000 - 2005 and in 2007. Qualitative analyses are based on in-depth interviews with 22 Black, White and Hispanic teen mothers residing in rural and urban areas of North Carolina conducted between November 2007 and February 2009. In quantitative analyses, 52% (196 of 389) of North Carolina teen mothers initiated breastfeeding, but half of those who initiated breastfeeding (92/196) stopped within the first month postpartum. Hispanic teens (44/52 or 89%) were much more likely than Black (61/159 or 41%) or White teens (87/164 or 52%) to initiate breastfeeding and to continue for a longer duration. Nearly sixty two percent (29/52) of Hispanic respondents breastfed for greater than four weeks as compared to 16% (29/159) of Black respondents and 26% (39/164) of White respondents. Common barriers to breastfeeding initiation and continuation included not liking breastfeeding, returning to school, nipple pain, and insufficient milk. Qualitative data provided context for the quantitative findings, elucidating the barriers and facilitators to breastfeeding from the teens' perspective and insight into the ways in which breastfeeding support to teens could be enhanced. The large number of adolescents ceasing breastfeeding within the first month points to the need for more individualized follow-up after hospital discharge in the first few days postpartum, to address common technical challenges and to provide assistance managing the transition back to school. Provision of an extra home visit or outpatient visit for teens within the first few days following hospital discharge, and advocacy to make schools more compatible with breastfeeding, could potentially help teens who desire to breastfeed to successfully continue. These interventions warrant further research to test their effectiveness among adolescents.
    International Breastfeeding Journal 09/2011; 6(1):14. DOI:10.1186/1746-4358-6-14
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    • "Immigrants in the United States generally have higher breastfeeding initiation rates than U.S. born women [1-3]. A study of Hispanic and black women and their country of origin found that foreign born black and Hispanic women were more likely to intend to only breastfeed than U.S. born women (42% vs 24%) [2]. "
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    ABSTRACT: The purpose of this exploratory study was to examine Cambodian refugee mothers' infant feeding beliefs, practices, and decision making regarding infant feeding in the U.S. and to explore if a culturally-specific breastfeeding program is appropriate for this community. A self-administered questionnaire and a 30 minute in-person interview were used to collect information from nine women. The audio-taped interviews were transcribed, answers compiled, and themes from each question identified. All participants practiced either traditional Cambodian diet (pregnancy and postpartum diet including, tnam sraa, herbs mixed with either wine or tea), traditional Cambodian rituals (like spung, amodified sauna) or both, despite having lived in the U.S. for many years. All nine women initiated breastfeeding, however eight women introduced infant formula while in hospital. Perceived low milk supply and returning to work were the main reasons cited for partial breastfeeding and early cessation of breastfeeding. While causes of initiation of other foods are similar to those found in the U.S. as a whole, a culturally-specific Cambodian breastfeeding support program may help overcome some breastfeeding problems reported by Cambodian refugee mothers who have immigrated to the United States.
    International Breastfeeding Journal 02/2008; 3(1):2. DOI:10.1186/1746-4358-3-2
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    ABSTRACT: Objetivos: estudiar la prevalencia de la lactancia materna en la poblacion inmigrante y espanola de una consulta pediatrica de Atencion Primaria de Madrid y determinar la influencia del tabaquismo en el inicio y el mantenimiento de la lactancia materna. Sujetos y metodos: estudio retrospectivo transversal, realizado con los datos obtenidos mediante cuestionarios de 506 ninos de hasta 7 anos de edad, pertenecientes a una consulta de Atencion Primaria de Madrid. Se utilizo el test de ¿Ô2 y la odds ratio para comparar los porcentajes. Se realizo analisis multivariante con regresion logistica y regresion lineal multiple. Resultados: del total de ninos estudiados, el 16,4% eran hijos de inmigrantes, sus madres iniciaron lactancia materna en un 86,7% de los casos y la mantuvieron a los 3 meses un 75,9%. Declararon fumar el 14,4% de las mujeres extranjeras. El analisis multivariante mostro que ser hijo de inmigrante esta asociado positivamente, y pesar menos de 2,5 kg negativamente, con el inicio de la lactancia materna; el mantenimiento a los 3 meses esta asociado negativamente con el sexo masculino del nino, el peso inferior a 2,5 kg al nacer y el tabaquismo materno. La regresion lineal multiple mostro que ser hijo de inmigrante y la edad del nino son factores predictivos positivos mientras que el tabaquismo materno gestacional y el sexo varon del nino lo son negativos para la duracion de la lactancia materna. Conclusiones: las mujeres inmigrantes inician la lactancia materna en mayor proporcion que las espanolas pero no la mantienen a los 3 meses. A esa edad tienen menos probabilidades de recibir lactancia materna los recien nacidos varones, los de bajo peso y los hijos de madres fumadoras.
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