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Abstract #147762

Kimberly Niles Newton, MPH, Jana Chaudhuri, PhD, and Anne Merewood, MPH, IBCLC. Division of General Pediatrics, Boston Medical Center, 88 East Newton St, Vose 3, Boston, MA 02118, 617 414 6466, kim.newton@bmc.org

Background: Latina women in the US have high breastfeeding initiation rates, but also high rates of formula supplementation, beginning in the hospital postpartum. The American Academy of Pediatrics recommends 6 months of exclusive breastfeeding. Objective: To examine factors affecting exclusive breastfeeding among Latinas at an urban, US Baby-Friendly Hospital. Methods: We obtained demographic and feeding data from hospital records on 231 healthy, breastfeeding-eligible Latina women and their newborns at Boston Medical Center in 2004-5. Pairs were excluded for contraindications to breastfeeding, NICU admission, and maternal complications that might compromise breastfeeding (such as psychiatric disorders with complex medication), to obtain a sample optimally capable of exclusive breastfeeding. We compared exclusively breastfeeding versus mixed feeding pairs across these variables using univariate and multivariate logistic regression. Results: The mean age of mothers was 26.8; 84% of women received public subsidized insurance such as Medicaid; 13.4% were US born; 65.4% were non-US born; for 21.2% birthplace was unknown or undocumented. 73.2% had a vaginal birth, 56.7% were assisted by midwives, and 43.4% by physicians. 39.4% of mothers also had a doula (a lay childbirth assistant). 24.7% of women exclusively breastfed, 68.0% mixed fed, and 7.4% formula fed. Comparing exclusive breastfeeders with mixed feeders in univariate analysis, younger age (OR 0.83; 95% CI 0.87-0.98), US birthplace (OR 2.85; 95% CI 1.14-7.12), and vaginal birth (OR 2.28; 95% CI 1.04-5.02) were predictors of exclusive breastfeeding. Additionally, the presence of a doula increased the likelihood of exclusive breastfeeding at a level approaching statistical significance (p=0.06). In multivariate logistic regression analysis including maternal age, insurance, birthplace, and type of delivery, younger maternal age (AOR 0.88; 95% CI 0.81-0.96) and vaginal delivery (AOR 2.81; 95% CI 1.01-7.81) remained significant predictors of exclusive breastfeeding. Conclusion: The strongest predictor of exclusive breastfeeding among a healthy Latina population was vaginal delivery; women with vaginal delivery had almost 3 times the odds of exclusively breastfeeding than women with cesarean birth. Further investigation is needed to determine why cesarean birth in a Baby-Friendly hospital would be associated with formula supplementation.

Learning Objectives:

• Define exclusive breastfeeding.
• Identify the demographic and clinical practices associated with exclusive breastfeeding among Latina women.
• Articulate the barriers to exclusive breastfeeding among Latina women.

Keywords: Breast Feeding, Hispanic

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.