Impact of Breastfeeding Barriers on Racial/Ethnic Disparities in Breastfeeding Outcomes in North Dakota.

IF 3.2 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2025-04-01 Epub Date: 2024-02-23 DOI:10.1007/s40615-024-01943-z

Anna Ross, Cora MacPherson, Lannesse Baker, Soojung Kim, Grace Njau, Andrew D Williams

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引用次数: 0

Abstract

Objective: Exclusive breastfeeding is recommended for the first 6 months of life, but there are racial/ethnic disparities in meeting this recommendation.

Methods: 2017-2020 North Dakota Pregnancy Risk Assessment Monitoring System (weighted N = 11,754) data were used to examine racial/ethnic differences in the association between self-reported breastfeeding barriers and breastfeeding duration. Breastfeeding duration was self-reported breastfeeding at 2 and 4 months, and number of weeks until breastfeeding cessation. Self-reported breastfeeding barriers were yes/no responses to 13 barriers (e.g., "difficulty latching," "household duties"). Logistic regression estimated odds ratios and 95% confidence intervals to determine if barriers accounted for breastfeeding disparities by race/ethnicity. Cox proportional hazard models estimated hazard ratios for stopping breastfeeding for American Indian and other race/ethnicity individuals, compared to White individuals. Models were adjusted for birthing parents' demographic and medical factors.

Results: Logistic regression results suggest American Indian birthing parents had similar odds for breastfeeding duration (2-month duration: OR 0.94 (95%CI 0.50, 1.77); 4-month duration: OR 1.24 (95%CI 0.43, 3.62)) compared to White birthing parents, after accounting for breastfeeding barriers. Cox proportional hazard models suggest American Indian birthing parents had a lower hazard of stopping breastfeeding (HR 0.76 (95%CI 0.57, 0.99)) than White parents, after accounting for breastfeeding barriers.

Conclusions: Accounting for breastfeeding barriers eliminated observed disparities in breastfeeding outcomes between American Indian and White birthing parents. Targeted and culturally safe efforts to reduce barriers to breastfeeding are warranted to reduce racial/ethnic disparities in breastfeeding.

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母乳喂养障碍对北达科他州母乳喂养结果中种族/族裔差异的影响。

目标：方法：利用 2017-2020 年北达科他州妊娠风险评估监测系统（加权 N = 11754）数据，研究自我报告的母乳喂养障碍与母乳喂养持续时间之间的种族/民族差异。母乳喂养持续时间是指自我报告的 2 个月和 4 个月的母乳喂养情况，以及直至停止母乳喂养的周数。自我报告的母乳喂养障碍是对 13 种障碍（如 "吮吸困难"、"家务"）的 "是"/"否 "回答。逻辑回归估算了几率比和 95% 的置信区间，以确定障碍是否是造成不同种族/族裔母乳喂养差异的原因。Cox 比例危险模型估算了与白人相比，美国印第安人和其他种族/人种停止母乳喂养的危险比。模型根据生育父母的人口和医疗因素进行了调整：结果：逻辑回归结果表明，美国印第安人分娩父母的母乳喂养持续时间与白人相似（持续时间为 2 个月，OR 为 0.94 (95%C) ）：OR 0.94 (95%CI 0.50, 1.77)；持续 4 个月：在考虑母乳喂养障碍后，与白人生育父母相比，印第安人生育父母的母乳喂养持续时间的几率相似（持续 2 个月的几率为 0.94（95%CI 为 0.50，1.77）；持续 4 个月的几率为 1.24（95%CI 为 0.43，3.62））。考克斯比例危险模型表明，在考虑母乳喂养障碍后，美国印第安人生育父母停止母乳喂养的危险性（HR 0.76 (95%CI 0.57, 0.99)）低于白人父母：结论：考虑母乳喂养障碍后，美国印第安人和白人新生儿父母在母乳喂养结果上的差异得以消除。为了减少母乳喂养中的种族/民族差异，有必要采取有针对性的、文化上安全的措施来减少母乳喂养的障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.