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Abstract Background In addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity a...
Contexts in source publication
Context 1
... simplicity, we use P < 0.01 which maintains our 95% confidence in our set of analyses as a whole. Table 2 describes the sample. A total of 10,159 women were included in the final analysis, most of whom were 25-29 years old (31.1%), non-Hispanic White (69.9%), ...Context 2
... 80% of the sample received adequate or adequate plus prenatal care, 85.1% had a prebirth conversation with a healthcare worker about breastfeeding, 10.9% reported experiencing postpartum depression, and 15.2% smoked at the time of the survey. Differences were found between food security groups for most socioeconomic, psychosocial, and physiological characteristics (Table 2). ...Context 3
... < 0.01). Patterns of early breastfeeding cessation were also significantly different between the two groups (P < 0.01; Table 2). Notably, among food secure women, the highest percentage of early breastfeeding cessation occurred during 4-6 weeks (9.1%), whereas the largest percentage of food insecure women stopped breastfeeding between 1 and 3 weeks (12.2%), followed by 7-9 weeks (11.7%). ...Context 4
... simplicity, we use P < 0.01 which maintains our 95% confidence in our set of analyses as a whole. Table 2 describes the sample. A total of 10,159 women were included in the final analysis, most of whom were 25-29 years old (31.1%), non-Hispanic White (69.9%), ...Context 5
... 80% of the sample received adequate or adequate plus prenatal care, 85.1% had a prebirth conversation with a healthcare worker about breastfeeding, 10.9% reported experiencing postpartum depression, and 15.2% smoked at the time of the survey. Differences were found between food security groups for most socioeconomic, psychosocial, and physiological characteristics (Table 2). ...Context 6
... < 0.01). Patterns of early breastfeeding cessation were also significantly different between the two groups (P < 0.01; Table 2). Notably, among food secure women, the highest percentage of early breastfeeding cessation occurred during 4-6 weeks (9.1%), whereas the largest percentage of food insecure women stopped breastfeeding between 1 and 3 weeks (12.2%), followed by 7-9 weeks (11.7%). ...Similar publications
This study examined the relationship between maternal food source and preparation during pregnancy and the duration of breastfeeding among 751 mother–child dyads in the United States. The data collected from the Environmental influences on Child Health Outcomes (ECHO) Program included twelve cohorts of mothers (age ≥ 18) who delivered infant(s). Th...
Food insecurity (FI) is an understudied risk factor for depression among perinatal women in sub-Saharan Africa. We therefore explored the longitudinal relationship between FI and depressive symptoms among a cohort of perinatal women of mixed HIV status (n = 371) in Kenya (NCT02974972, NCT02979418). Using longitudinal linear and logistic regressions...
We examined the association between household food insecurity and early child development and whether or not maternal depression and anxiety modifies this association. The cross‐sectional study included 468 mother–infant pairs recruited at primary health centers of the Federal District, Brazil. Mothers answered a questionnaire that evaluated early...
Maternal depression symptoms are common in pregnant women and can have negative effects on offspring’s emotional development. This study investigated the association between prenatal maternal depression symptoms (assessed with the Edinburgh Postnatal Depression Scale at 24 weeks of gestation) and auditory perception of emotional stimuli in 3-year-o...
Introduction
A small number of literature has posited a link between prenatal exposure to gestational diabetes mellitus and an increased risk of developmental defects in the enamel of offspring. However, the evidence remains inconclusive.
Aims
This study examined the relationship between the diabetes status of mothers and the use of dental services...
Citations
... Decreased breastfeeding rates have been associated with higher levels of household food insecurity, [18][19][20] potentially contributing to perceived poorer maternal diet, high stress levels, and the limiting of healthy foods. 21 Initial recommendations during the beginning of the COVID-19 pandemic included mother-newborn separation and no direct breastfeeding. ...
... ; https://doi.org/10.1101/2025.02.07.25321881 doi: medRxiv preprint between food insecurity and exclusive breastfeeding duration and practices or with other poor feeding behaviors. 20,32,35,40 During other stressful conditions, such as natural disasters and conflict situations, mothers reported that lacking privacy, spaces conducive to breastfeeding, limited fluid and energy intake, stress, and exhaustion deterred them from breastfeeding. 41,42 Mothers may have similar concerns in the context of a pandemic. ...
Background: The COVID-19 pandemic has intensified economic hardships, with potential negative impacts on food insecurity and infant feeding beliefs and practices. The relationship between food insecurity and infant feeding beliefs and practices during the pandemic is not yet fully understood. Neither is how these relationships changed over the course of the waves of the pandemic. We examined these relationships in a cohort of infants born during the various waves of the COVID-19 pandemic in New York City (NYC).
Methods: We conducted a cross-sectional analysis of infants enrolled from birth into the COVID-19 Mother-Baby Outcomes (COMBO) study and born March 2020 to May 2024. We measured food insecurity in the prior 30 days with a 2-item survey adapted from Hunger Vital Sign, infant feeding confidence at hospital discharge, and current infant feeding practices.
Results: 40% of women in our sample had been exposed to prenatal SARS-CoV-2 infection and approximately 24% of mothers were food insecure. There was a significant association between food insecurity and prenatal SARS-CoV-2 infection, Spanish as one's preferred language, and self-identifying as Latina. In unadjusted models of the entire sample, food insecurity was associated with formula feeding (p<0.001), but this relationship was no longer significant after adjusting for covariates (p=0.059). In comparing the first and second waves of the pandemic (March 2020-December 2021 vs. January 2022-May 2024), there was no significant difference in rate of food insecurity. When comparing different waves of the pandemic, food insecurity was associated with increased likelihood of formula feeding, even after adjusting for confounders.
Discussion: Food insecurity was initially associated with feeding methods, but this relationship lost significance after adjusting for confounders. However, when analyzed separately, food insecurity was significantly linked to lower odds of exclusive breastfeeding during different waves of the pandemic, suggesting the influence of external factors like policy changes and social support variations. Other factors, such as maternal BMI, ethnicity, and delivery mode, were also significantly associated with breastfeeding practices, highlighting the need for targeted interventions to support breastfeeding, especially among food-insecure mothers.
... It is noteworthy that breastfeeding had a negative connotation in the context of HFI, where it had been described as a burden on mothers and a feeding practice that had poor benefits for the child; and on top of that, it happened at the expense of the mother' health, well-being, and nutritional status. Such attitudes were not previously reported in studies that had looked at coping mechanisms [48][49][50][51]. The food insecurity created stress, frustration, and despair among women who felt that they could not provide the basic needs (provision of adequate nutrition) to their children and therefore adopted some practical mechanisms to cope. ...
Background: Household food insecurity (HFI) is a serious public health concern in Lebanon. Adverse mental health issues have been reported among food insecure households in addition to physical and nutritional complications. Caregivers in food insecure families tend to adopt different coping mechanisms to mitigate the effects of food insecurity (FI) on their children. Objective: This cross-sectional observational study aimed to explore the relationship between FI, maternal depression, child malnutrition, and differential coping mechanisms adopted by mothers. Methods: A total of 219 women were enrolled in this study; FI was assessed using the household food insecurity assessment (HFIAS), maternal depression using the patient health questionnaire (PHQ-9), and their children’s nutritional status through recall of anthropometric measurements. Pearson’s correlations and logistic regressions were performed to evaluate the associations between HFI, maternal depression, and children’s nutritional status. Results: A strong positive correlation between HFI and maternal depression (p = 0.001) and children’s nutritional status (p = 0.008) was shown. Logistic regressions revealed that being food secure decreased the risk of maternal depression (OR = 0.328, 95% CI 0.125–0.863, p = 0.024), while it did not predict children’s nutritional status. Eight main themes related to coping mechanisms were identified. Conclusions: This study highlights the understudied relationship between food insecurity and maternal depression, showing an increased prevalence of HFI among residents in Lebanon with a positive correlation with increased maternal depression. Further investigation is warranted to better explore how to mitigate the negative impact of food insecurity on mental health, maternal nutritional needs, and Infant and Young Child Feeding (IYCF) practices in Lebanon.
... For example, a study of Illinois mothers (n = 103) enrolled in the Women, Infants, and Children (WIC) program found that married WIC participants were four times more likely to breastfeed for at least three months compared to single WIC participants [17]. Furthermore, a national study found a correlation between marital status and longer duration of breastfeeding, regardless of food security status [18]. Of note, as marriage rates are declining and rates of committed cohabitating couples increase [19], it is likely that the benefits of marriage on breastfeeding also apply to cohabiting families, given the similarities in relationship quality and financial circumstances between married and cohabiting couples [20,21]. ...
Background
Marriage promotes breastfeeding duration through economic and social supports. The COVID-19 pandemic disproportionately affected marginalized communities and impacted women’s employment and interpersonal dynamics. This study examined how marriage affects breastfeeding duration across socioeconomic and racially minoritized groups during COVID-19, aiming to inform social support strategies for vulnerable families in public health crises.
Methods
For this cross-sectional study, data were drawn from the 2017–2021 North Dakota Pregnancy Risk Assessment Monitoring System (weighted n = 41433). Breastfeeding duration was self-reported, and 2-, 4-, and 6-month duration variables were calculated. Marital status(married, not married) and education (< high school education, ≥high school education) were drawn from birth certificates. Income (≤ US48,000) and race/ethnicity (White, American Indian, Other) were self-reported. Infant birth date was used to identify pre-COVID (2017–2019) and COVID (2020–2021) births. Logistic regression estimated odds ratios and 95% confidence intervals for the association between marital status and breastfeeding duration outcomes. Models were fit overall, by COVID-19 era and by demographic factors. Lastly, demographic-specific models were further stratified by COVID era. Models were adjusted for maternal health and sociodemographic factors.
Results
Overall, married women consistently had 2-fold higher odds of breastfeeding across all durations during both pre-COVID and COVID eras. Pre-COVID, marriage was a stronger predictor for all breastfeeding durations in low-income women (4-month duration OR 4.07, 95%CI 2.52, 6.58) than for high-income women (4-month duration OR 1.76, 95%CI 1.06, 2.91). Conversely, during COVID, marriage was a stronger predictor of breastfeeding duration for high-income women (4-month duration OR 2.89, 95%CI 1.47, 5.68) than low-income women (4-month duration OR 1.59, 95%CI 0.80, 3.15). Findings were similar among American Indian women and those with less than high school education, in that both groups lost the benefit of marriage on breastfeeding duration during the COVID-19 pandemic.
Conclusion
Marriage promotes breastfeeding duration, yet the observed benefit was reduced for low-socioeconomic and racially minoritized populations during the COVID-19 pandemic. These observations highlight the disproportionate impacts low-socioeconomic and racially minoritized populations face during public health crises. Continued research examining how major societal disruptions intersect with social determinants to shape breastfeeding outcomes can inform more equitable systems of care.
... 11 Research examining the relationship between food-related SDOH and breastfeeding has focused primarily on food insecurity. [12][13][14] Living in a food desert is a relevant but understudied SDOH that may have important implications for racial/ethnic disparities in BFI, given that food deserts are disproportionally experienced by neighborhoods with predominantly minoritized populations. 15 Although food deserts and food insecurity are frequently used together when describing challenges in accessing nutritious food, each term addresses distinct aspects of this issue and could potentially hold different implications for breastfeeding. ...
Introduction: Breastfeeding is associated with improved health outcomes. Several social drivers of health impact breastfeeding initiation (BFI). Prior research using ecological data demonstrated that food desert residence (FDR) is associated with lower rates of BFI. The primary objective was to assess the relationship between FDR and BFI using individual-level data. The secondary objective was to assess the relationship between FDR and BFI at the county level. Methods: Individual-level birth data from the Florida Department of Health were linked to food access data from the United States Department of Agriculture Food Access Research Atlas in 2010, 2015, and 2019. Food deserts were identified per the United States Department of Agriculture definition. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were calculated using modified Poisson regression models in 573,368 births. Models were adjusted for confounders and stratified by race/ethnicity. We assessed the association between the percent of the population in low-income and low-access census tracts aggregated to the county level and the percent of mothers initiating breastfeeding per county in Florida (Center for Disease Control and Prevention) using Pearson's correlation and a bivariate map. Results: FDR was associated with BFI (aRR: 1.23, CI: 1.20-1.27). The adjusted risk of not-initiating breastfeeding for those living in a food desert was greatest among non-Hispanic Black women (aRR: 1.29, CI: 1.24-1.35) and Hispanic women (aRR: 1.29, CI: 1.21-1.37). Maternal education was the most significant predictor of BFI. Women who had 9th through 12th-grade education but without a diploma were five times (aRR: 4.96, CI: 4.72-5.20) less likely to initiate breastfeeding relative to college graduates. There was no association between FDR and BFI at the county level, though regional trends were noted. Conclusions: FDR is an important risk factor for not-initiating breastfeeding. Among Floridians, education was the most significant risk factor. Understanding how FDR influences breastfeeding can help target interventions to improve breastfeeding outcomes.
... On the other hand, structural barriers contributing to HFI, such as limited access to food, lack of or unstable employment, financial constraints and limited access to health care, can amplify inequities in breastfeeding practices (Dagla et al., 2021;Hoff et al., 2019;Turcksin et al., 2014). In this context, quantitative studies assessing the relationship between HFI and breastfeeding practices in different geocultural contexts have found inconsistent results (Dinour et al., 2020;Francis et al., 2024;Gomes & Gubert, 2012). Qualitative studies have suggested that HFI contributes to the early cessation of breastfeeding due to perceived insufficient quantity or low quality of breast milk (Lesorogol et al., 2018;Webb-Girard et al., 2012). ...
... Lack of or unstable employment can make food-insecure parents not entitled to comprehensive maternity protection (e.g., paid maternity leave, cash and medical benefits, job security, breaks on return to work and access to childcare) (Pereira- . Limited access to health care may limit access to breastfeeding education during prenatal care (Dinour et al., 2020;Mildon et al., 2023) and to culturally sensitive breastfeeding support postpartum (e.g., racially/ethnically diverse lactation consultants and facilitated access to breast pumps) (Quintero et al., 2023 inequities contributing to HFI that amplify disparities in breastfeeding practices (Dagla et al., 2021;Hoff et al., 2019;Turcksin et al., 2014). ...
Breastfeeding offers ideal food and nutrition for infants; however, structural barriers may amplify breastfeeding inequities. We aimed to identify whether household food insecurity (HFI) is associated with exclusive and continued breastfeeding (EBF and CBF) as recommended by the World Health Organization/United Nations Children's Fund (UNICEF) Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis, literature searches using ‘breastfeeding’, ‘food insecurity’ and ‘infant’ terms were conducted in PubMed/MEDLINE, Embase, CINAHL, Global Health and LILACS from inception through November 2023, without language restrictions, yielding 1382 publications (PROSPERO:CRD42022329836). Predetermined eligibility criteria yielded the 12 included studies (nine cross‐sectional and three cohorts). The risk of bias was assessed through the Effective Public Health Practice Project. Meta‐analysis was performed for studies assessing EBF (n = 10), and metaregression was used to explore heterogeneity across studies. Prevalence of EBF ranged from 1.6% to 85.3%, with a lower prevalence among HFI. The pooled effect of the association between HFI and EBF presented an odds ratio (OR) of 0.61 (95% CI = 0.49–0.76) with consistent results across marginal (OR = 0.72, 95% CI = 0.55–0.94), moderate (OR = 0.59, 95% CI = 0.41–0.84) and severe HFI (OR = 0.49, 95% CI = 0.32–0.76). High heterogeneity was found only when HFI was dichotomized. The prevalence of CBF ranged from 35.4% to 78.0%, with inconsistent prevalence among HFI; a meta‐analysis was not performed due to the low number of studies (n = 3). We concluded that HFI levels are associated with lower odds of EBF. Integrating service and policy‐level strategies, such as screening, referrals, skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/UNICEF breastfeeding recommendations among food‐insecure families.
... However, this effect disappeared in the final model (OR 1.17; 95% CI 0.92-1.48) [17]. Additionally, Orozco et al. (2020) reported in the final model a nonsignificant increase in the odds of non-total duration of breastfeeding among households that experienced food insecurity in non-Hispanic Caucasians (OR 1.45; 95% CI 0.83-2.54), ...
... For his part, Dinour et al. (2020) found that women with food insecurity during a 12-month period had a 35% risk of stopping breastfeeding during the fourth and sixth week compared to women with food security (RR 0.65; 95% CI 0.50-0.85) [17]. ...
... In this study, we analyzed the most relevant information regarding food security or insecurity and its relationship with breastfeeding practices. Hence, we found that this association exists, as was reported by multiple authors [16,17,20,[22][23][24][25]. Moreover, Orr et al. (2018) found an association between the initiation and duration of breastfeeding and their level of food security [16]. ...
Breastfeeding is the fundamental, physiological, and psychosocial process by which the mother feeds the newborn. Early initiation of breastfeeding is recommended within the first hour of life and exclusive breastfeeding up to six months of age due to its optimal contribution of nutrients for the development of the newborn. Despite this, there are factors that affect this process which involve the nutritional, physical, and psychological state of the mother, such as food security or food insecurity, however, it is unknown if it will have a decisive impact on these factors concerning the cessation of breastfeeding or total duration of breastfeeding. This study is an in-depth review of the available information related to food security as a determinant in breastfeeding practices. We did a scoping review between December 2022-January 2023. The principal inclusion criteria were: the use of the English language, qualitative and quantitative methods, and analytical studies. All the articles were available in full text and the manuscripts ranged from 1997 and 2022. Twelve studies were included: eight quantitative, two qualitative, and two mixed. In the quantitative studies, significant positive and negative associations were found between food insecurity, exclusive breastfeeding, early initiation of breastfeeding, cessation of breastfeeding, and total duration of breastfeeding. For their part, qualitative and mixed studies describe that women with severe food insecurity tend to feel weak and may have a poor perception of their diet and, consequently, their breastfeeding practices are lower. Moreover, there are qualitative studies that mention that the higher the food insecurity, the more frequently breastfeeding occurs. The inconsistency in the results may be due to factors involving the characteristics of each population, the instrument used to measure food security, and the variables by which the models were adjusted. It is necessary to carry out more studies on the subject since it is obvious that the relationship between the variables needs to be clarified.
... The 19 articles included in this review were primarily quantitative, consisting of 9 cohort studies 23-31 and 8 cross-sectional studies. 2,[32][33][34][35][36][37][38] Two qualitative studies were included. 39,40 Multiple definitions and measurement tools to assess household food security were identified. ...
... 32,40 Four quantitative studies investigated the effect of food insecurity on breastfeeding initiation and continuation. [32][33][34]38 Studies addressed additional child-specific outcomes, including restrictive and pressured feeding styles, 32 or specific feeding behaviors such as early introduction of solid foods before 4 or 6 months of age 38 or adding cereal to a baby bottle during feeds 32 as a result of food insecurity. None of the included studies investigated positive maternal health outcomes associated with breastfeeding, such as postpartum weight loss, involution promotion, decreased postpartum bleeding, or improvements in glucose metabolism for mothers diagnosed with GDM. ...
... 2,23,39 Participation in federal government assistance programs, such as SNAP and WIC, ranged from 30% to 90%. 2,33,34,37,39,40 Support from such programs was consistently described as insufficient to support food security. 39 When parents decided to feed their infant formula, the assistance was also insufficient, as the monthly stipend decreased. ...
Background: Food insecurity is a major public health concern in the United States, particularly for pregnant and postpartum individuals. In 2020, ∼13.8 million (10.5%) U.S. households experienced food insecurity. However, the association between food security and pregnancy outcomes in the United States is poorly understood.
Purpose: The purpose of this review was to critically appraise the state of the evidence related to food insecurity as a determinant of health within the context of pregnancy in the United States. We also explored the relationship between food insecurity and pregnancy outcomes.
Methods: PubMed, CINAHL, Web of Science, and Food and Nutrition Science databases were used. The inclusion criteria were peer-reviewed studies about food (in)security, position articles from professional organizations, and policy articles about pregnancy outcomes and breastfeeding practices. Studies conducted outside of the United States and those without an adequate definition of food (in)security were excluded. Neonatal health outcomes were also excluded. Included articles were critically appraised with the STROBE and Critical Appraisal Skills Program checklists.
Results: Nineteen studies met the inclusion criteria. Inconsistencies exist in defining and measuring household food (in)security. Pregnant and postpartum people experienced several adverse physiological and psychological outcomes that impact pregnancy compared with those who do not. Intersections between neighborhood conditions and other economic hardships were identified. Findings regarding the impact of food insecurity on breastfeeding behaviors were mixed, but generally food insecurity was not associated with poor breastfeeding outcomes in adjusted models.
Conclusion: Inconsistencies in definitions and measures of food security limit definitive conclusions. There is a need for standardizing definitions and measures of food insecurity, as well as a heightened awareness and policy change to alleviate experiences of food insecurity.
... In a qualitative study, low-income, Hispanic mothers perceived that lack of access to healthy food impacted their milk quality [26], and the authors surmised that maternal beliefs about stress, limited access to nutritious foods, and an unhealthy maternal diet might lead to decreased breastfeeding. In another study, Dinour and colleagues found that food-secure mothers were significantly more likely to breastfeed than mothers experiencing food insecurity [27]. Further, a recent study examining the impact of COVID-19 on breastfeeding demonstrated that mothers who lived in more resourced communities had more positive breastfeeding experiences during lockdown than those who lived in less resourced communities [28]. ...
Background
Breastfeeding has long-lasting effects on children’s cognition, behavioral, mental and physical health. Previous research shows parental characteristics (e.g., education, race/ethnicity, income level) are associated with breastfeeding initiation and duration. Further, research shows significant variation in access to community resources by race/ethnicity. It is unclear how community resources may impact breastfeeding practices and how this might intersect with maternal race/ethnicity.
Methods
This study combined nationally-representative data from the Study of Attitudes and Factors Effecting Infant Care (SAFE), which surveyed US mothers immediately after the infant’s birth and at two to six months of infant age, with the Child Opportunity Index (COI) 2.0, a census tract measure of community resources associated with child development, to explore the association between community resources and breastfeeding initiation and whether this varies based on maternal race/ethnicity and country of birth. The SAFE Study used a stratified, two-stage, clustered design to obtain a nationally representative sample of mothers of infants, while oversampling Hispanic and non-Hispanic (NH) Black mothers. The SAFE study enrolled mothers who spoke English or Spanish across 32 US birth hospitals between January 2011 and March 2014.
Results
After accounting for individual characteristics, mothers residing in the highest-resourced communities (compared to the lowest) had significantly greater likelihood of breastfeeding. Representation in higher-resourced communities differed by race/ethnicity. Race/ethnicity did not significantly moderate the association between community resources and breastfeeding. In examining within race/ethnic groups, however, community resources were not associated with non-US born Black and Hispanic mothers’ rates of breastfeeding, while they were with US born Black and Hispanic mothers.
Conclusions
Findings suggest that even health behaviors like breastfeeding, which we often associate with individual choice, are connected to the community resources within which they are made. Study implications point to the importance of considering the impact of the contextual factors that shape health and as a potential contributor to understanding the observed race/ethnicity gap.
... It is noteworthy that breastfeeding had a negative connotation in the context of HFI, where it had been described as a burden on mothers and a feeding practice that had poor benefits for the child; and on top of that, it happened at the expense of the mother' health, well-being, and nutritional status. Such attitudes were not previously reported in studies that had looked at coping mechanisms [48][49][50][51]. The food insecurity created stress, frustration, and despair among women who felt that they could not provide the basic needs (provision of adequate nutrition) to their children and therefore adopted some practical mechanisms to cope. ...
... Despite breastfeeding being a low-cost and highquality food source for infants vulnerable to food insecurity, relatively few North American studies have examined the association between food insecurity and breastfeeding. [20][21][22] A study conducted in Canada found that food insecurity was not a predictor of breastfeeding initiation, but food insecure individuals were significantly less likely to exclusively breastfeed through 4 months. 20 However, this study failed to control for certain parturient factors known to affect breastfeeding, and its power was limited due to a relatively small number of individuals with food insecurity in the sample. ...
... 21 Similarly, a recent study conducted in six US states found that the association between food insecurity and breastfeeding initiation became non-significant after controlling for socioeconomic, psychosocial, and physiological factors. 22 However, this study may have lacked the sensitivity to identify food insecure participants as it only assessed this variable with a single question. In contrast, our study used a three-question USDA-validated measure of food insecurity to better capture food insecurity and its effect on infant feeding practices. ...
Background
Breastfeeding rates in the United States are suboptimal despite public health recommendations that infants are fed breastmilk for their first year of life. This study aimed to characterize the influence of social determinants of health on intended breastfeeding duration.
Methods
This case–control study analyzed breastfeeding intent in 421 postpartum women. Data on social determinants and medical history were obtained from medical records and participant self‐report. Logistic regression estimated the influence of demographic factors and social determinants on intent to breastfeed for durations of <6 months, 6–12 months, and at least 1 year.
Results
Thirty‐five percent of mothers intended to breastfeed for at least 6 months, and 15% for 1 year. Social determinants that negatively predicted breastfeeding intent included not owning transportation and living in a dangerous neighborhood (p < 0.05). Women were more likely to intend to breastfeed for 12 months if they had knowledge of breastfeeding recommendations (adjusted odds ratio [aOR] 6.19, 95% confidence interval [CI 2.67–14.34]), an identifiable medical provider (aOR 2.64 [CI 1.22–5.72]), familial support (aOR 2.80 [CI 1.01–7.80]), or were married (aOR 2.55 [CI 1.01–6.46]). Sociodemographic factors that negatively influenced breastfeeding intent included non‐Hispanic Black race, no high school diploma, cigarette use, income below $20,000, fewer than five prenatal visits, and WIC or Medicaid enrollment (p < 0.05).
Conclusions
Women who lack familial support, an identifiable healthcare provider, or knowledge of breastfeeding guidelines are less likely to intend to breastfeed. Public health initiatives should address these determinants to improve breastfeeding and infant outcomes.
