BACKGROUND: Although exclusive breastfeeding is highly recommended for infants’ optimal growth, little is known about barriers to exclusive breastfeeding. This study aimed to determine estimates of exclusive breastfeeding and explore barriers associated with it in Mississippi.
METHODS:
The 2009-2011 Mississippi Pregnancy Risk Assessment Monitoring (PRAMS) data were analyzed in this study (n=3,775). PRAMS is an on-going national surveillance system designed to identify and monitor maternal behaviors and experiences before, during and after pregnancy among women delivering a live birth. Proportions and 95% CIs for exclusive breastfeeding for at least 8 weeks by levels of selected characteristics were calculated, and differences were assessed using chi-square tests. In order to assess barriers associated with exclusive breastfeeding for at least 8 weeks, we used multiple logistic regression. Variables were included in the multiple logistic regression model if their p-value was less than 0.20 on bivariate analysis. All analyses accounted for the complex sample design and unequal selection probabilities.
RESULTS: The overall prevalence of exclusive breastfeeding for at least 8 weeks was 15.5%. In unadjusted analyses, mothers who had less than high school education (9.4%), less than $25,000 annual income (8.8%), unintended pregnancy (11.8%) or those who were black (10.4%), unmarried (9.5%) or aged <20 years old (6.5%) had lower prevalence of exclusive breastfeeding for at least 8 weeks. Adjusted analyses indicated that being black (OR=0.72, 95% CI=0.53-0.97, reference=white), having high school education (OR=0.36, 95% CI=0.24-0.54, reference=college degree), and less than 20 years of age (OR=0.52, 95% CI=0.30-0.91, reference=30 years or more) were independently associated with a decreased likelihood of being exclusive breastfed for at least 8 weeks.
CONCLUSIONS: Younger mothers, those who have less education, and black mothers are less likely to breastfeed exclusively. The findings suggested that interventions need to focus on certain subgroups in order to increase exclusive breastfeeding.