Nativity, country of education, and Mexican-American women's breastfeeding patterns the first 10 months postpartum

background. Mexican-American women historically have high breastfeeding rates; however, these rates vary by nativity and time in the U.S.  Further, evidence is mixed regarding whether Mexican-American women with stronger ties to their country of origin exclusively breastfeed more often and for longer durations, or if they are at elevated risk for very early supplementation—a phenomenon known as “los dos.”  In this study we investigate the current and exclusive breastfeeding patterns of Mexican-American women from delivery to 10 months postpartum to determine the influences of nativity and country of education amidst influential sociocultural factors on breastfeeding behaviors.

methods. Data are from a prospective cohort study of postpartum Mexican-American women aged 18-44 from Texas (n=593, 62.7% born in Mexico).  We used a series of logistic regression models to assess the direct effects of nativity and country of education on breastfeeding practices at delivery, 3, 7, and 10 months postpartum while controlling for salient covariates at each time point.

results. Women completing their education in Mexico had higher rates of overall breastfeeding throughout the study period.  This trend held in multivariate models while diminishing over time.  However, among breastfeeding mothers, those born in Mexico had lower rates of exclusive breastfeeding than those born in the U.S. in bivariate models.  Contextual factors explained away this difference in multivariate models.

conclusions. In addition to nativity, country of education should be considered when assessing Mexican-American women’s risk for breastfeeding discontinuation and supplementation to inform more targeted and culturally-appropriate breastfeeding promotion programming.