From Ross Products Division, Abbott Laboratories, Columbus, Ohio.
Objective. To update reported rates of breastfeeding through 1995 and to compare rates in 1995 with those from 1989.
Methods. The Ross Laboratories Mothers' Survey, first conducted in 1955, is a large, national, mail survey designed to determine patterns of milk feeding to 6 months of age. Questionnaires are mailed to a representative sample of mothers when their infants are 6 months of age. In 1989, 196 000 questionnaires were mailed, and in 1995, 720 000 questionnaires were mailed. Mothers were asked to recall the type of milk fed to their infants immediately after birth, in the hospital, and during each of the first 6 months of age. The rates of breastfeeding in the hospital and at 6 months of age were evaluated.
Results. The Ross Laboratories Mothers' Survey demonstrates recent increases in both the initiation of breastfeeding and continued breastfeeding at 6 months of age. Comparing rates in 1989 and 1995, the initiation of breastfeeding increased more than 14% (from 52.2% to 59.7%). There was a 19.3% increase in the rate of breastfeeding at 6 months of age (from 18.1% to 21.6%). The increases in breastfeeding were observed across all sociodemographic groups but were greater among groups that have historically been less likely to practice breastfeeding: women who were black, younger (<25 years of age), in the lowest income group (<$10 000), no more than grade school educated, primiparous, and living in the South Atlantic region of the United States; women who had infants of low birth weight; women who were employed full time outside the home; and women who participated in the Women, Infants, and Children supplemental food program. Nevertheless, breastfeeding was most common in the western states and among women who were older, college educated, and multiparous, did not enroll in the Women, Infants, and Children program, were not employed outside the home, had infants of normal birth weight, and had higher disposable incomes.
Conclusion. The sharp increase in rates of breastfeeding among groups that are less likely to breastfeed is encouraging. However, these groups are still the least likely to initiate breastfeeding. Educational efforts that extol positive attitudes about breastfeeding must be continued to support mothers who are young, poor, and less educated. breastfeeding, infant feeding, demography.
Information on breastfeeding has been collected by the Ross Products Division of Abbott Laboratories since 1955.1 These surveys were designed to determine patterns of infant feeding during the first 6 months of life. Ryan et al1 described declines both in the initiation of breastfeeding and continued breastfeeding at 6 months of age between 1984 and 1989. The declines in breastfeeding were seen across all groups but were greater in some groups than in others. The declines in the initiation of breastfeeding were greater among younger and poorer mothers than among older and more affluent mothers. For breastfeeding at 6 months of age, the declines were greater among younger and primiparous mothers than among older and multiparous mothers. Similarly, women enrolled in the Women, Infants, and Children (WIC) supplemental food program (compared with those not enrolled), those with less than a college education (compared with those with some college education), and those not living in the western region of the United States (compared with those residing in the West) were less likely to initiate breastfeeding or to practice breastfeeding when their infants were 6 months of age.
The present study updates reported rates of breastfeeding through 1995 and compares these rates with those in 1989. We describe rates of the initiation of breastfeeding and continued breastfeeding to a least 6 months of age according to several sociodemographic factors. We also relate region of residence to breastfeeding.
We found that there has been a resurgence in the prevalence of the initiation of breastfeeding and the persistence of breastfeeding to 6 months of age. Although increases in breastfeeding were observed across all socioeconomic groups, the increases were more marked among groups that have historically been less likely to breastfeed.
Prevalence of Breastfeeding by Demographic Characteristics: 1989 Versus 1995
As shown in the Figure, initiation of breastfeeding increased steadily since 1971 to its highest level in 1982. The prevalence of the initiation of breastfeeding declined approximately 13% from 1984 to 1989 (59.7% in 1984 and 52.2% in 1989).1 Since 1989, the prevalence of the initiation of breastfeeding dramatically increased more than 14%, matching the level attained in 1984 (59.7%) (Table 1). Only in 1982 was the prevalence of the initiation of breastfeeding greater (61.9%) than it was in 1995.
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Table 1. Breastfeeding in the Hospital and at 6 Months of Age by Selected Demographic Characteristics, 1989 Through 1995 |
25 years), in the highest income group (
$25 000/y), college educated, employed part time, multiparous, not
in the WIC program, and living in the Mountain and Pacific regions of
the United States, and women who had infants of normal birth weight. In
1995, more than three of every four infants living in the Mountain and
Pacific regions of the United States were initially breastfed.
35 years), in the highest income group
(
$25 000), and college educated; women who did not participate in
the WIC program; and women who were living in the Mountain and Pacific
regions.
Geographic Influences on Breastfeeding
Table 2 illustrates the extent to which region of residence influences the initiation of breastfeeding and continued breastfeeding to at least 6 months of age. Mothers who resided in the western states (Mountain and Pacific regions) were more likely to breastfeed than those who resided elsewhere, regardless of their ethnic and racial background or WIC participation status. Notably, a higher percentage of black mothers living in the Pacific region of the United States than white mothers living in the Middle Atlantic, East North Central, or East South Central regions nursed their infants in the hospital. Similarly, relatively more black women living in the Pacific region breastfed their infants at 6 months of age than did white women living in other regions of the United States.|
Table 2. Breastfeeding in the Hospital and at 6 Months of Age by Region of Residence and Women, Infants, and Children (WIC) Supplemental Food Program Participation Status, 1995 |
Received for publication Oct 15, 1996; accepted Nov 26, 1996.
Reprint requests to (A.S.R.) Ross Products Division, Abbott Laboratories, 625 Cleveland Ave, Columbus, OH 43215.
I am grateful for the efforts of Linda Goode, Jeff Wysong, and John Mizera for their statistical support.
WIC, Women, Infants, and Children. RLMS, Ross Laboratories Mothers' Survey.
State Agency Participation and Expenditure Report,
Fiscal Year 1989. Washington DC: US Department of Agriculture;
1989
State Agency Participation and Expenditure Report,
Fiscal Year 1995. Washington DC: US Department of Agriculture;
1995This article has been cited by other articles:
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