178797 Smoking, environmental tobacco smoke (ETS) exposure and other correlates of breastfeeding among African American women

Monday, October 27, 2008: 2:45 PM

Susan M. Blake, PhD , School of Public Health and Health Services, George Washington University Medical Center, Washington, DC
Marie Gantz, PhD , Statistics and Epidemiology Unit, RTI International, Rockville, MD
M. Nabil El-Khorazaty, PhD , Statistics and Epidemiology Unit, RTI International, Rockville, MD
Lorien Abroms, ScD , School of Public Health and Health Services, George Washington University Medical Center, Washington, DC
Ayman El-Mohandes, MD, MBBCh, MPH , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Kathy S. Katz, PhD , Department of Pediatrics, Georgetown University Medical Center, Washington, DC
Michele Kiely, DrPH , Division of Epidemiology, Statistics & Prevention Research, National Institute of Child Health and Human Development/NIH, Rockville, MD
Purpose: To identify correlates of breastfeeding among AA women.

Methods: 792 low income AA women enrolled in a randomized trial to reduce pregnancy risks were interviewed 2-4 months postpartum (PP) about breastfeeding. Dependent variables included: any breastfeeding (BF; yes/no), breastfeeding duration (BD) and time-to-first bottle feeding (TBF). Bivariate comparisons using Chi-square tests and ANOVAs, and multivariable logistic regression analyses identified factors associated with BF, BD and TBF.

Results: 55% reported BF; BD was short (24%, 1-4 weeks; 26%, 5-11 weeks; 5%, 12+ weeks), as was TBF (<1 week PP, 71%). Inverse associations were found with cigarette smoking (CS) and ETS exposure (ESTE): BF (CS, 44%; ETSE, 55%; neither, 60%; p<.0001), BD >5 weeks (CS, 18%; ETSE, 29%; Neither, 38%; p<.0001) and TBF <1 week (CS, 79%; ETSE, 73%; Neither, 65%; p<.05). The odds of BF was increased among women with a partner (OR=1.71; 95% CI=1.09-2.68), with depression symptoms at study entry (OR=1.64; 95% CI=1.15-2.35), and decreased with less than (OR=0.48; 95% CI=0.29-0.79) or equal to HS education(OR=.57, 95% CI=0.37-0.90) compared to college, US birth (OR=0.09; 95% CI=0.02-0.45), multiparity (OR=0.63; 95% CI=0.43-0.92), positive drug tox screen (OR=0.52; 95% CI=0.29-0.95) and HIV+ (OR=0.02; 95% CI=0.00-0.22). IPV, smoking since delivery, cotinine level, and ETSE did not contribute to the final model of BF. Results for BD and TBF will be presented.

Conclusions: Breastfeeding initiation and duration were low, and associated with multiple demographic, psychosocial and other factors, including breastfeeding contraindications, but not with CS or ETSE, in this sample of AA women.

Learning Objectives:
1) Describe Healthy People 2010 recommendations for breastfeeding initiation, duration and timing of bottle feeding. 2) List 5 important factors to consider in promoting breastfeeding initiation and duration among low income African American Women.

Keywords: Breast Feeding, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: History of work in MCH, with pregnant women, and in pregnancy, HIV and STD prevention
Any relevant financial relationships? No

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.