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

Authors

Anna Ross, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA.
Cora MacPherson, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA.
Lannesse Baker, University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
Soojung Kim, Department of Communication, University of North Dakota, O'Kelly Hall Room 202, 221 Centennial Drive Stop 7169, Grand Forks, ND, 58202-7169, USA.
Grace Njau, North Dakota Department of Health & Human Services, 600 E Boulevard Ave Dept 325, Bismarck, ND, 58505, USA.
Andrew D. Williams, University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA. andrew.d.williams@und.edu.

Document Type

Journal Article

Publication Date

2-23-2024

Journal

Journal of racial and ethnic health disparities

DOI

10.1007/s40615-024-01943-z

Keywords

American Indian; Barriers; Breastfeeding; Indigenous; PRAMS; Racial disparities

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.

APA Citation

Ross, Anna; MacPherson, Cora; Baker, Lannesse; Kim, Soojung; Njau, Grace; and Williams, Andrew D., "Impact of Breastfeeding Barriers on Racial/Ethnic Disparities in Breastfeeding Outcomes in North Dakota" (2024). GW Authored Works. Paper 4319.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4319

Department

Epidemiology