Racial/Ethnic Differences in Breastfeeding Initiation and Duration Among Low-income, Inner-city Mothers

Objectives. Despite the promotion of breastfeeding as the “ideal” infant feeding method by health experts, breastfeeding continues to be less common among low-income and minority mothers than among other women. This article investigates how maternal sociodemographic and infant characteristics, household environment, and health behaviors are related to breastfeeding initiation and duration among low-income, inner-city mothers, with a specific focus on differences in breastfeeding behavior by race/ethnicity and nativity status. Methods. Using data from a community-based, longitudinal study of women in Philadelphia, PA (N=1,140), we estimate logistic regression and Cox proportional hazard models to predict breastfeeding initiation and duration. Results. Both foreign-born black mothers and Hispanic mothers (most of whom were foreign born) were significantly more likely to breastfeed their infants than non-Hispanic white women, findings that were partly explained by foreign-born and Hispanic mothers' prenatal intention to breastfeed. In contrast to previous studies, we also found that native-born black women were more likely to breastfeed than non-Hispanic white women. Conclusion. Our findings suggest that when poor whites and African Americans are similarly situated in an inner-city context, the disparity in their behavior with respect to infant feeding is not as distinct as documented in national surveys. Breastfeeding was much more common among low-income immigrant black women than among white or native-born black mothers.