Racial and ethnic disparities in breastfeeding among United States infants: Third National Health and Nutrition Examination Survey, 1988-1994

Background: The studies suggesting that blacks are less likely to initiate and maintain breastfeeding than whites in the United States are limited either by the representativeness of the sample or by the ambiguousness of attribution of racial and ethnic disparities to generally poor socioeconomic status among blacks. The Purpose of this study was to examine racial and ethnic disparities in breastfeeding rates among U.S. infants using national representative data. Methods: We analyzed breastfeeding data reported by parents of children ages 12 to 71 months at the time of interview from the Third National Health and Nutrition Examination Survey (1988-1994). Breastfeeding data were stratified by both race and ethnicity, and by a series of sociodemographic and health-related characteristics. Results: The proportion of children ever breastfed was 60 percent among non-Hispanic whites, 26 percent among non-Hispanic blacks, and 54 percent among Mexican Americans. By 6 months postpartum, the proportion still breastfed decreased to 27, 9, and 23 percent, correspondently. Blacks also had a significantly lower rate of exclusive breastfeeding at 4 months than whites (14%). In addition, the differentials in breastfeeding rates between high and low socioeconomic classes were most substantial among blacks. Conclusions: Blacks had consistent lower breastfeeding rates than whites regardless of their sociodemographic status. The large differentials between high and low socioeconomic classes among blacks suggest that socioeconomic status has a bigger impact on breastfeeding practices among blacks. Therefore, blacks, particularly those who are poor or less educated, need to be targeted for promotion, protection, and support of breastfeeding.