Rates and Predictors of Breastfeeding Initiation and Continuation: Findings from 2009-2011 Mississippi Pregnancy Risk Assessment Monitoring System (PRAMS)

Monday, June 20, 2016: 10:57 AM
Tubughnenq' 3, Dena'ina Convention Center
Mina Qobadi , Mississippi State Department of Health, Jackson, MS
Lei Zhang , Mississippi State Department of Health, Jackson, MS
BACKGROUND:  

Although breastfeeding is highly recommended for infants’ optimal growth, little is known about breastfeeding in Mississippi. We aimed to determine estimates of breastfeeding initiation, continuation and associated factors in Mississippi.

METHODS:  

The 2009-2011 Mississippi PRAMS data were analyzed in this study (n=3,775).We analyzed two questions from PRAMS questionnaire: 1) “Did you ever breastfeed or pump breast milk to feed your new baby after delivery, even for a short period of time?”; 2) “How many weeks or months did you breastfeed or pump milk to feed your baby?”. We calculated breastfeeding continuation with timing for at least 8 weeks for second question. Descriptive statistics, Chi-square tests and logistic regressions were done using SAS 9.4 Proc Survey procedures.

RESULTS:  

In Mississippi, 51.3% and 26.8% of the mothers had ever breastfed and continued breastfeeding for at least 8 weeks, respectively. Rates of breastfeeding initiation were higher among mothers who had intended pregnancy (60.4%, p<0.0001), college degree (78.7%, <0.0001) or annual income of $35,000 or more (72.5%, p<0.0001) or those who were non-smoker (54.6%, p=0.03), white (63.8%, p<0.0001), married (66.8%, p<0.0001) or aged ≥30 years old (62.3%, p<0.0001). Like breastfeeding initiation, rates of breastfeeding continuation at least for 8 weeks were higher among mothers who had intended pregnancy (34.3%, p<0.0001), college degree (53.7%, <0.0001) or annual income of  $35,000 or more  (42.9%, p<0.0001), those who were non-smoker (29.4%, p<0.0001), white (32.9%, p<0.0001), married (38.3%, p<0.0001) or aged ≥30 years old (37.1%, p<0.0001). After adjusting for potential confounding variables, mothers with college degree (OR=3.2, 95% CI=2.1-4.8, ref<high school education), and those who were white (OR=1.9, 95% CI=1.5-2.4, ref=black) and married (OR=1.4, 95% CI=1.1-1.7, ref=other) were more likely to initiate breastfeeding. For breastfeeding continuation, women with college degree (OR=2.6, 95% CI=1.7-3.9, ref<high school education), aged 25-29 years (OR=2.2, 95% CI=1.4-3.5, ref<20 years), and those who were white (OR=1.5, 95% CI=1.1-1.9, ref=black) and non-smoker (OR=1.8, 95% CI=1.3-2.5, ref=smoker) were more likely to continue breastfeeding for at least 8 weeks. Pregnancy intention and annual income were not associated with breastfeeding initiation and continuation in adjusted model indicating other factors such as short maternity leave and employment may be associated with breastfeeding.

CONCLUSIONS:  

Both ever breastfeeding and breastfeeding continuation rates were low in Mississippi and they were significantly associated with mothers’ educational level and race. Further, smoking is a strong predictor of breastfeeding discontinuation. The findings suggested that interventions need to focus on certain subgroups in order to increase breastfeeding.