Multidimensional assessment of acculturation associated with significant differences in exclusive breastfeeding rates among Latinas

Hispanic breastfeeding rates are affected by acculturation; however, most research assesses acculturation as a unidimensional construct. Our objective was to evaluate the relationship between acculturation and breastfeeding rates (any and exclusive) among low-income Latinas, using a 20-item modified ARMSA-II multidimensional scale. Data were analyzed from an ongoing randomized trial, which recruited pregnant Latinas planning to breastfeed. Acculturation data were collected at 36 weeks gestation. The Anglo Orientation Subscale (AOS) and the Hispanic Orientation Subscale (HOS) were used to classify participants as Very Hispanic Oriented, Bicultural, or Strongly Anglo Oriented. Infant feeding practices were assessed at 2 weeks and 1 month postpartum via telephone. Among the 85 women surveyed to date, the AOS and HOS were reliable (Cronbach alpha = 0.95 and 0.83, respectively). Rates of exclusive breastfeeding (EBF), but not of any breastfeeding, were significantly associated with acculturation level. Bicultural women were less likely to EBF at 2 weeks and 1 month (17.5% vs 40.5% and 14.7% vs 35.9%, respectively), compared to those strongly oriented as Hispanic or Anglo (p<0.05). EBF rates at 1 month were nearly identical for those strongly oriented as Hispanic vs strongly oriented as Anglo (36.0% vs 35.7%, respectively). Additionally, mean time living in the US was significantly different between strongly Hispanic, bicultural and strongly Anglo groups (5.5±3.6, 14.4±8.4 and 20.7±7.4 years, respectively; p<0.001). These preliminary findings suggest that a multidimensional assessment of acculturation should be included as part of EBF promotion programs. Funded by NIH/NCMHD grant # P20MD001765.