Acculturation, Education and Breastfeeding Duration Along the US-Mexico Border

Background: Studies of breastfeeding initiation along the US-Mexico border have found that Hispanics have relatively low rates of breastfeeding initiation compared to whites, and the effects of acculturation and immigrant status do not mirror national trends. Factors affecting duration have been less studied. Methods: We used data from a postpartum hospital survey in El Paso, Texas to investigate the effect of measures of acculturation (country of birth, location of last school attended, language preference) on duration among Hispanic women reporting breastfeeding their previous child. Logistic and Cox regression were used to determine the association between acculturation and early discontinuation (< 6 months) and overall risk of stopping. Results: Among women with a prior birth (n=1394), 48% reported breastfeeding their previous child, and 50% stopped before 6 months. More than 30% of women who stopped before 6 months wanted to breastfeed longer, citing insufficient milk, return to work and breast discomfort as reasons for discontinuation. Education level, rather than acculturation, was associated with early discontinuation and increased risk of stopping in logistic and Cox models, respectively. Relative to women with primary school education or less, women with less than high school or complete high school education were significantly more likely to stop breastfeeding before 6 months (OR: 1.56, OR: 1.67, respectively) and had greater overall risk of stopping (RR: 1.22, RR: 1.40). Discussion: Factors usually associated with breastfeeding duration among Hispanics fail to predict duration along the US-Mexico border. Providers in this area should target breastfeeding support at women with more education.