African-American women less likely to breastfeed, narrowing gap could drop infant mortality
Note: This information is embargoed by the journal Pediatrics until Monday, Aug. 6, 5 p.m. ET. Study author Renata Forste is best reached before she leaves the country July 28 at (801) 378-3146 (office) or (801) 221-3793 (home). After July 28, contact BYU press officer Michael Smart at (801) 378-7320 or [email protected] For a copy of the study, contact the AAP Office of Public Relations at (847) 434-7131
PROVO, Utah -- African-American women are 40 percent as likely to breastfeed their infants as non-black women, and this disparity accounts for the race gap in U.S. infant mortality at least as well as low birth weight does, according to a new study by researchers at Brigham Young University.
"The decision to breastfeed or bottle feed is an individual choice," said Renata Forste, associate professor of sociology at BYU and lead author on the study published in the August issue of Pediatrics. "It's important to give people information about that choice and important that everyone has equal access to that information. Our study identifies a high-risk population that particularly would benefit from increased public and medical support for breastfeeding."
Forste's team used statistical models to analyze survey results collected from more than 1,000 women with children 18 months or younger in the 1995 National Survey of Family Growth conducted by the Centers for Disease Control and Prevention. Sixty-five percent of white women had breastfed their babies -- 30 percent of African-American women had breastfed theirs. After accounting for other factors like income level, education, marital status and age, race remained a strong predictor of breastfeeding. Further statistical analysis found that increasing the amount of infants breastfed could lower African-American infants' mortality rate, which currently stands at 1.3 times that of whites.
Previous research cited in the BYU study shows that breastfeeding is the healthiest way for a newborn to get the best nutrition possible and that breast milk provides antibodies that are effective in preventing illness. Forste hopes the medical community will increase its efforts to share those findings with all mothers.
''It seems that women -- particularly African-American women -- are choosing the bottle over breastfeeding because they lack information about its benefits and especially because they lack support to breastfeed from the medical community, peers, and American culture in general," she said. "It's not easy to breastfeed -- the social norm is generally not supportive of breastfeeding."
When asked why they did not breastfeed their babies, 83 percent of African-American surveyed chose the response "preferred to bottle-feed." Sixty-two percent of white women chose this response. Other choices were "job or schedule difficulties" and "physical and medical difficulties." Forste recommended further research into factors influencing African-American women's decision whether to breastfeed, especially since another aspect of her study highlights the crucial role breastfeeding plays in infant mortality.
Most previous research into the cause of higher African-American infant mortality focuses on low birth weight. The BYU analysis notes that whether an infant was ever breastfed is just as important. The study found that breastfed infants are 80 percent less likely to die before age 1 than those who are never breastfed, even after accounting for low birth weight.
"The encouragement of breastfeeding needs to be a priority for health care providers," said Forste, who earned her doctorate at the University of Chicago in 1992. "If physicians and other health care workers can successively increase the percentage of black infants being breastfed, the infant mortality gap between blacks and whites should close."
The study's other findings:-- Women are less likely to breastfeed their last child if they state they don't plan to have any more children.-- Women in western states are 3.6 times more likely to breastfeed their babies than women in the rest of America.-- College-educated women are twice as likely to breastfeed their babies as women whose education does not extend beyond high school.-- Foreign-born women are 75 percent more likely to breastfeed their babies than American-born women.
Forste, who was assisted on the study by then-BYU students Jessica Weiss and Emily Lippincott, hopes the recognition of August 1-7 as World Breastfeeding Week and similar efforts will raise awareness of the practice's benefits.
"Ultimately, breastfeeding is not a race issue, nor a women's issue. It is important for public health in general," she said. "Breastfeeding is always more successful if women have the support of partners and friends. In terms of public health and cost savings, everyone benefits from breastfeeding."
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