Reasons Why Women Do Not Initiate Breastfeeding: A Southeastern State Study
Received 1 October 2008; received in revised form 18 February 2009; accepted 17 March 2009.
Purpose
Despite the increase in breastfeeding initiation and duration in the United States, only five states have met the three Healthy People 2010 breastfeeding objectives. Our objectives are to study women's self-reported reasons for not initiating breastfeeding and to determine whether these reasons vary by race/ethnicity, and other maternal and hospital support characteristics.
Methods
Data are from the 2000–2003 Arkansas Pregnancy Risk Assessment Monitoring System, restricting the sample to women who did not initiate breastfeeding (unweighted n=2,917). Reasons for not initiating breastfeeding are characterized as individual reasons, household responsibilities, and circumstances. Analyses include the χ2 test and multiple logistic regression.
Results
About 38% of Arkansas mothers of live singletons did not initiate breastfeeding. There was a greater representation of non-Hispanic Blacks among those who did not initiate breastfeeding (32%) than among those who initiated breastfeeding (9.9%). Among those who never breastfed, individual reasons were most frequently cited for noninitiation (63.0%). After adjusting for covariates, Hispanics had three times the odds of citing circumstances than Whites (odds ratio [OR], 3.07; 95% confidence interval [CI], 1.31–7.18). Women who indicated that the hospital staff did not teach them how to breastfeed had more than two times greater odds of citing individual reasons (OR, 2.25; 95% CI, 1.30–3.91) or reasons related to household responsibilities (OR, 2.27; 95% CI, 1.19–4.36) as compared with women who indicated they were taught.
Conclusions
Findings suggest the need for targeting breastfeeding interventions to different subgroups of women. In addition, there are implications for policy particularly regarding breastfeeding support in hospitals.
aDepartment of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
bDepartment of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
cDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
dDivision of Health Services Administration, Graduate School of Public Health, San Diego State University, San Diego, California
Correspondence to: Chinelo A. Ogbuanu, MD, MPH, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208; Phone: 803-667-4690; Fax: 803-777-1836.
ABSTRACT