Prenatal and perinatal factors associated with breast-feeding initiation among inner-city Puerto Rican women

Objective To identify factors associated with the initiation of breast-feeding in a predominantly Puerto Rican population living in inner-city Hartford, Conn. Design Retrospective study of 144 Latino women (mean+/- standard deviation age=26.3+/-5.7 years) with children at least 1 year old but younger than 6 years old (mean+/-standard deviation age=3.0+/-1.2 years) at the time of the survey. Women were recruited from agencies sponsoring health programs for mothers and children. They were interviewed in their homes (69%) or at the Hispanic Health Council, Hartford, Conn (31%). Subjects/setting Low-income Latino women who had at least 1 preschooler at the time of the interview. The women lived in inner-city Hartford, and the overwhelming majority were Puerto Rican and received welfare assistance and food stamps. Seventy-eight percent of the women chose to be interviewed in Spanish; the other 22% were interviewed in English. Statistical analyses Explanatory variables that related to breast-feeding initiation (P less than or equal to.2) in bivariate chi(2) analyses were entered into a multivariate logistic regression model that was reduced using backward stepwise elimination procedures. Results Multivariate analyses indicated that breast-feeding the previous child, shorter length of maternal residence in the United States, not receiving prenatal bottle-feeding advice, more recent birth, and higher birth weight were positively associated with breast-feeding initiation. A major reason for choosing not to breast-feed was that women felt socially uncomfortable doing it. Applications Breast-feeding initiation was more likely in Latino women who received prenatal breast-feeding counseling and postpartum support. Mothers of low-birth-weight infants and women breast-feeding for the first time may need additional help. These findings can be used by programs like the Special Supplemental Nutrition Program for Women, Infants, and Children to increase breast-feeding initiation.