Provider's help/encouragement and breastfeeding practices in los angeles county (LAC): Findings from the 2010 los angeles mommy and baby (LAMB) survey

Background Despite the large body of breastfeeding research, studies addressing the timing of providers' help/encouragement and breastfeeding practices are limited. We examined provider's help/encouragement on breast feeding practices in two time periods: at the delivery hospital and well-baby checkup.

Methods LAMB is a mail survey based on clustered sampling design. For non-respondents, we follow up with telephone interviews/calls. We analyzed the 2010 LAMB data (n=6,517, response rate=57%). Multiple logistic regression was used to assess providers' encouragement on breastfeeding practices after controlling for important confounders (race, education, marital status, foreign born, health insurance, prenatal care, and LBW baby). Results Ninety percent of respondents were encouraged by a healthcare professional to breastfeed at the delivery hospital while 66% received such encouragement during the well-baby checkup. Provider encouragement at the delivery was positively related to breastfeeding initiation (aOR= 2.6, CI:1.8-3.8) but not with continuous breastfeeding at 3 months duration (aOR=0.8,CI:0-1.1,CI:1.8-3.8). However, encouragement received at the well-baby checkup was positively associated with continuous breastfeeding at 3 months duration (aOR=1.5, CI:1.2-1.9). African American women or women who received less than a high school education were less likely to initiate (aOR=2.4,1.7, respectively) or continue breastfeeding (aOR=2.1,1.8, respectively).

Discussion This study illustrates the importance of training physicians and nurses to support breastfeeding. Providers should continue to provide encouragement to mothers after the mothers leave the hospital. Special efforts should target African American mothers and women who received less than 12 years of education.