184832 Relationship between income distribution and breastfeeding initiation rates in a “Low Income” population: A 3-year comparative analysis

Monday, October 27, 2008: 5:30 PM

Dr. Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Marycatherine Augustyn, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Susan M. Gross, PhD, MPH, RD , Food Supplement Nutrition Education, University of Maryland Cooperative Extension, Columbia, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
Caitlin Cross-Barnet, MA , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Linda Kelly , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
David M. Paige, MD MPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
The relationship between income and breastfeeding initiation is recognized. Higher income is associated with higher initiation. Variation in breastfeeding rates within low income populations however, is poorly documented. The objective of this 3-year comparative analysis was to evaluate variations in race-income level effects on breastfeeding initiation rates (BFIR) among three cohorts in the Maryland Women, Infants and Children(WIC) program.

We analyzed BFIR for 30,000+ infants annually, between 2005 and 2007. Each year, approximately half the participants were non-Hispanic African Americans (AA); Hispanic/Latinos and non-Hispanic Whites were evenly distributed. Annual household income (HHI) ranged from less than $1800 to $100,000. Participants reporting no HHI was 15%.

Overall BFIR were approximately 56% for each year, Hispanic/Latino participants had the highest BFIR (80%); non-Hispanic African Americans and whites had lower rates (47%). BFIR were lowest (44%) in the lowest HHI quintiles and highest (64%) among the highest HHI quintile. Exclusive breastfeeding rates were almost twice as high for the highest HHI groups (9.5%) as for the lowest HHI (5%). Hispanics with the highest HHI had the highest BFIR (83%), while Whites and AA in the same HHI bracket had BFIR between 53% and 57%. The odds of BFI was lowest among participants with the lowest HHI compared to BFI among higher HHI groups after controlling for covariates. This study demonstrates the variation of BFIR for income groups within a defined low income population. When designing effective breastfeeding promotion programs to target groups with the lowest BFIR, income variation must be taken account.

Learning Objectives:
1. Describe variations in income distribution and breastfeeding initiation rates in "Low-Income" populations 2. Analyze the relationship between income distribution and breastfeeding initiation rates in "Low-Income" populations 3. Evaluate strategies for targeting ""Low-Income" population sub-groups to improve breastfeeding initiation rates and achieve Healthy People 2010 goals.

Keywords: Breastfeeding, Low-Income

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been extensively involved in MCH research, teaching and community service for the last 30 years on improving women's and children's health
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.

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