Breastfeeding Duration among Roma and non-Roma Mothers Living in Underdeveloped Regions of Hungary

Background: We explored factors associated with breastfeeding duration among new mothers living in Hungary, a country with a robust maternal and child health (MCH) service.   Methods: This research is part of a retrospective cohort study (2009-2012) that included over 18,000 in-person interviews conducted by the MCH nurses among new mothers living in the underdeveloped regions of Hungary.  Our analytical included women interviewed ≥52 weeks after delivery, with self-reported ethnicity and complete breastfeeding duration data (n=4,053).   Results: Almost all women initiated breastfeeding (95%).  However, 61% of those who initiated stopped breastfeeding between 0-12 weeks, while 38% continued breastfeeding for 1 year. Using logistic regression and 99% confidence intervals, Roma women were almost twice as likely as non-Roma women to breastfeed for 1+ years (OR=1.93, 99%CI 1.43-2.60).  Factors associated with a lower likelihood of breastfeeding for one year included: mother being underweight (OR=.64, 99%CI=-.45-0.91), smoking during pregnancy (OR=.64, 99%CI 0.51-0.80), and having a pre-term infant (OR=0.48, 99%CI=0.33-0.70). Non-significant controls included socioeconomic status, mother’s marital status and age, and whether the pregnancy was planned. Conclusions: Studies have documented the devastating socioeconomic conditions of the Roma and the corresponding negative health effects. Our study demonstrates that Roma women are much more likely than non-Roma to continue breastfeeding for one year, which has positive implications for mother and child.  However, high rates of smoking during pregnancy overall (30%), especially among the Roma versus non-Roma (53% vs. 21%, respectively) suggests the need for a multi-faceted intervention to promote maternal and child health in Hungary.