Race and Intention to Breastfeed are the Strongest Predictors of Exclusive Breastfeeding: a Retrospective Study.

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

Journal of Racial and Ethnic Health Disparities Pub Date : 2024-12-01 Epub Date: 2023-10-05 DOI:10.1007/s40615-023-01819-8

Lauren Sartor, Chantal Pyram-Vincent, Hung-Mo Lin, Yuxia Ouyang, David B Wax, Yaakov Beilin

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引用次数: 0

Abstract

Introduction: Racial disparities exist in maternal and neonatal care including breastfeeding (BF). The purpose of this study is to assess factors associated with BF success by race with a specific focus on pre-birth BF plan and time duration from birth until initiation of skin-to-skin contact and from birth to the first feed or breastfeed.

Methods: A database query of our electronic medical records was performed for all patients who had a vaginal delivery that met our study criteria. Demographic information, pre-delivery feeding plan (exclusive BF, exclusive formula, or mixed), time to first feed and first breastfeed, and time to skin-to-skin were compared among different postpartum feeding practices (exclusive BF, exclusive formula, mixed), and compared across race/ethnic groups using ANOVA, Chi-square, and Fisher's exact statistical tests as appropriate. Logistic regression was used to investigate the independent effect of each variable on exclusive BF.

Results: The study analyzed 12,578 deliveries. There was a significant difference in intended feeding plans among the different racial groups. Approximately 61% of Black patients intended to exclusively BF as compared to 79% of the other groups. Overall, 3994 (32%) patients breastfed exclusively, 872 (7%) exclusively used formula, and 7712 (61%) used a mix of breast and formula. White patients were most likely to exclusively BF (35%) and Black patients were least likely (21%), p < 0.001. Our model found that self-identified race and pre-delivery feeding plan were the strongest predictors of exclusive BF.

Conclusions: The main findings of this study are that self-identified race and intention to BF are the strongest predictors of exclusive BF. Black patients intend to BF at a significantly lower rate than other racial groups, for reasons not determined by this study, and this affects feeding practice. Our findings are notable because prehospital intention to BF can be modified by outreach, education, and changes to in-hospital practices.

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种族和母乳喂养意愿是纯母乳喂养最有力的预测因素：一项回顾性研究。

引言：包括母乳喂养在内的孕产妇和新生儿护理存在种族差异。本研究的目的是按种族评估与BF成功相关的因素，特别关注出生前BF计划和从出生到开始皮肤接触以及从出生到第一次喂养或母乳喂养的持续时间。方法：对所有符合我们研究标准的阴道分娩患者的电子医疗记录进行数据库查询。比较不同产后喂养方式（独家BF、独家配方奶粉、混合）的人口统计信息、产前喂养计划（独家BF，独家配方奶粉或混合）、首次喂养和首次母乳喂养的时间以及皮肤对皮肤的时间，并酌情使用ANOVA、卡方和Fisher精确统计检验在不同种族/民族之间进行比较。采用Logistic回归分析各变量对排异BF的独立影响。结果：本研究分析了12578例分娩情况。不同种族群体的预期喂养计划存在显著差异。大约61%的黑人患者打算只做BF，而其他群体的这一比例为79%。总体而言，3994名（32%）患者完全母乳喂养，872名（7%）患者完全使用配方奶粉，7712名（61%）患者混合使用母乳和配方奶粉。白人患者最有可能只患BF（35%），黑人患者最不可能（21%），p 结论：本研究的主要发现是，自我认同的种族和BF意愿是排他性BF的最强预测因素。由于本研究未确定的原因，黑人患者的BF意愿明显低于其他种族群体，这影响了喂养实践。我们的研究结果值得注意，因为BF的院前意向可以通过外展、教育和院内实践的改变来改变。

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.