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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    • "These analyses rely on a subset of Latino fathers with complete data on the outcome variables. Consequently, there is no appropriate sampling weight to account for this particular subgroup or for the longitudinal nature of the analyses within a subgroup, thus unweighted estimates are presented (e.g., Choi & Jackson, 2011; Gibson-Davis & Brooks-Gunn, 2006; Turney, 2010). In all multivariate analyses robust standard errors are used to account for the possible nonindependence of observations within cities. "
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    ABSTRACT: The relationship between Latino fathers' immigrant status and their involvement with their 12-month-old infants was examined using the Fragile Families data set, a longitudinal birth cohort study. We examined differences among 787 immigrant and nonimmigrant Latino fathers along three dimensions of father involvement- accessibility, engagement, and caretaking, as reported by both mothers and fathers. First generation immigrant fathers were more accessible to their infants, but showed lower levels of engagement with and caretaking of their children compared to nonimmigrant fathers, controlling for numerous background factors. Immigrant fathers' lower level of engagement was partially mediated by fathers' traditional attitudes. Findings indicate that there may be some culturally different norms for immigrant fathering. Culturally-relevant measures of fathering should be included in future large-scale studies, including constructs such as familism and acculturation.
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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.
    Full-text · Article · Sep 2011 · International Breastfeeding Journal
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    • "These factors differ for each of the main transmission routes and change during a lifetime, making it difficult to precisely explain what drives CMV seroprevalence results and what accounts for racial or ethnic differences. For instance, possible explanations include breast-feeding rates, household demographic factors and child care arrangements, and sexual behaviors and networks, all of which differ substantially by race or ethnicity343536373839 . However, there is no clear correlation between these racial/ethnic variations in exposure to prominent CMV transmission modes and the likelihood of being CMV seropositive. "
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    ABSTRACT: BACKGROUND. Congenital cytomegalovirus (CMV) infection causes permanent disabilities in more than 5500 children each year in the United States. The likelihood of congenital infection and disability is highest for infants whose mothers were CMV seronegative before conception and who acquire infection during pregnancy. METHODS. To provide a current, nationally representative estimate of the seroprevalence of CMV in the United States and to investigate trends in CMV infection, serum samples from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 were tested for CMV-specific immunoglobulin G antibody, and results were compared with those from NHANES III (1988-1994). Individuals aged 6-49 years (21,639 for NHANES III and 15,310 for NHANES 1999-2004) were included. RESULTS. For NHANES 1999-2004, the overall age-adjusted CMV seroprevalence was 50.4%. CMV seroprevalence was higher among non-Hispanic black and Mexican American children compared with non-Hispanic white children and increased more quickly in subsequent age groups. CMV seropositivity was independently associated with older age, female sex, foreign birthplace, low household income, high household crowding, and low household education. Compared with NHANES 1988-1994, the overall age-adjusted CMV seroprevalence for NHANES 1999-2004 was not significantly different. CONCLUSIONS. Many women of reproductive age in the United States are still at risk of primary CMV infection during pregnancy. There is an urgent need for vaccine development and other interventions to prevent and treat congenital CMV. The substantial disparities in CMV risk among seronegative women suggest that prevention strategies should include an emphasis on reaching racial or ethnic minorities and women of low socioeconomic status.
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