262239 Disparities in breastfeeding practices by children's health needs in the United States

Wednesday, October 31, 2012

Cambria Wilhelm, MPH , Dept. of Pediatrics, Oregon Health & Science University, Child and Adolescent Health Measurement Initiative, Portland, OR
Elizabeth Adams, PhD, RD , Oregon Health and Sciences University, Portland, OR
Christina Bethell, PhD, MBA, MPH , Department of Pediatrics, School of Medicine, The Child and Adolescent Health Measurement Initiative, Oregon Health & Science University, Portland, OR
Jodi A. Lapidus, PhD , Department of Public Health and Preventive Medicine, Oregon Health Sciences University, Portland, OR
Background: Breastfeeding is accepted as the best possible feeding for infants; however the prevalence remains well below national goals. Previously identified barriers include social norms, inadequate support, infant admission into intensive care, hospital policy and practices, and infant becoming sick. Methods: Data source is the 2007 National Survey of Children's Health for children age 0-5 years (n=37,374). Chi-squared tests were used to establish associations between demographic factors and special health care needs or high risk of developmental, behavioral or social delays (SHCN/DBSD) and breastfeeding initiation and duration. Multivariate logistic regression was used to obtain adjusted odds ratios. Results: The odds of breastfeeding among SHCN/DBSD children were 18% lower than for other children (95% CI: 3-30%). Among children who were ever breastfed, the odds that SHCN/DBSD children stopped prior to six months were 26% higher than for other children (95% CI: 10-40%). Other factors associated with breastfeeding were income, mother's health status, geographical region, family structure, household tobacco use, child's birth position, mother's education and race/ethnicity. Conclusions: Results suggest that mothers of children with increased health needs face more barriers to breastfeeding. Understanding barriers is vital to providing support and reducing this disparity faced by CSHCN. Breastfeeding is also less common for children living below the federal poverty level and those exposed to tobacco inside the home, indicating often children who were not breastfed optimally are also exposed to other negative health risk factors.

Learning Areas:
Advocacy for health and health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Evaluate the relationship between child’s health needs (as represented by having special health care needs or being at high risk of developmental, behavioral or social delay) and breastfeeding initiation and 6 month duration among children age 0-5 years in the United States.

Keywords: Breast Feeding, Children With Special Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This was my thesis for my Master of Public Health degree and I have worked with data from the National Survey of Children's Health for over two years.
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.