Maternal factors associated with intention to exclusively breastfeed or breast and formula feed among urban minority women

Background: Prenatal maternal intention to breastfeed is a major predictor of successful breastfeeding practices. Objective: To examine the association of maternal factors on the intention to exclusively breastfeed or breast and formula feed in an urban minority population. Design/Methods: We conducted a cross sectional survey of women whose infants were born 7/10-9/10 and discharged from the term nursery at an academic community hospital in Philadelphia, PA. Prior to delivery, women were asked how they planned to feed their infant: exclusively breastfeed, breast and formula, or formula. We used multivariate ordinal logistic regression to assess associations of ethnicity, age, parity, pregravida BMI, and insurance on the odds of intention to exclusively/ partially breastfeed. Results: The study population included 680 mothers: 18% <19 ys, 25% >30 yrs; 60% were African American, 18% Latinas; 85% had Medicaid. 56% of mothers intended to breastfeed (44% exclusively, 12% breast and formula), 37% formula and 7% undecided. Older mothers were more likely to intend to breastfeed exclusively than to use both breast and formula or to use formula alone (p= 0.02) controlling for all other factors. Similar results were found for women with higher BMI ( p=0.001) and lower parity (p=0.002). Ethnicity and type of insurance were not independent predictors of intent to breastfeed (p>0.26). Conclusions: In an urban minority population, intention to breastfeed was low overall and many women either plan to breast and formula feed or have not made deliberate decisions before birth. Strategies are needed to promote breastfeeding prenatally among urban minority women.