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APHA Scientific Session and Event Listing

Elizabeth Racine, DrPH, RD, Health Behavior and Administration, University of North Carolina at Charlotte, 9201 University City Blvd, Barnard 225, Charlotte, NC 28210, 704-752-5929, efracine@uncc.edu, Kevin Frick, PhD, Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm 606, Baltimore, MD 21205-1901, Joanne Guthrie, RD, PhD, Food and Nutrition Research Program, USDA-Economic Research Service, 1800 M St NW, RM N-2154, Washington, DC 20036, and Donna Stobino, PhD, Population and Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, E4151, Baltimore, MD 21205-1901.

•Objective. To test whether potential barriers to breastfeeding experienced by 2-4 months were predictive of breastfeeding cessation by 12 months postpartum. •Design. Data from the Healthy Steps National Evaluation (HSNE) were used for this study. Thirty-nine potential barriers were identified and tested as predictors of breastfeeding cessation by 12 months. •Subjects/setting. The HSNE is a longitudinal child development intervention that followed a cohort of children from birth to three years of age in 24 pediatric sites throughout the U.S. enrolled from 1996-1998. A sample of low income families that initiated breastfeeding were used for this analysis, n=1,598. •Statistical analyses performed. Cox proportional hazards model was used to predict breastfeeding cessation to 12 months. •Results. A smoker in the household (HR 1.34), the mother experiencing depressive symptoms (HR 1.16), the mother not attending a postpartum doctors visit (HR 1.39), the father not in the home (HR 1.38), WIC participation at 2-4 months (HR 1.50), the doctor not encouraging breastfeeding (HR 1.19) and not receiving help with breastfeeding at the pediatric office (HR 1.20) were negatively associated with breastfeeding continuation. There was a dose response relationship found for women returning to work and the risk of cessation: <20 hours/wk (HR 1.29), >20 –40 hours/wk (HR 1.47), and >40 hours/wk (HR 1.52). •Conclusions. The findings indicate that assistance and support from the health care sector (doctors, nurses, lactation consultants, or WIC nutritionists) in the postpartum period would increase the number of low-income women breastfeeding to 12 months.

Learning Objectives:

• To discuss the various barriers to breastfeeding continuation experienced by low-income women.
• To evaluate the current health care system and discuss how it impacts breastfeeding continuation.

Keywords: Low-Income, Breastfeeding

Presenting author's disclosure statement:

Any relevant financial relationships? No