P3.B025: Examining How Various Maternal Factors Affect Rate of Breastfeeding For Six Months and Beyond

Background: The AAP recommends exclusive breastfeeding for the first 6 months of life to help immune system development. Exclusive breastfeeding during this time has been linked to decreased rates of upper respiratory infections and otitis media as well as decreased future risk of obesity and metabolic disease. Our objective was to determine if maternal demographic factors such as race, ethnicity, age, educational level, primary language, urbanicity, and income were associated with breastfeeding for at least six months.

Methods: A cross-sectional study was performed using data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS) for 2020 and 2021. PRAMS is conducted in 46 states, the District of Columbia, and US territories, accounts for 81% of live births, and assesses maternal behaviors and experiences occurring before, during, and after pregnancy. For the purpose of this analysis, only mothers of infants 6 months or older were included. Descriptive statistics were conducted to determine the number of mothers who: never initiated, breastfed/fed breast milk < 1 month, breastfed/fed breast milk 1 to < 6 months, and breastfed/fed breast milk 6+ months. A binary logistic regression was conducted to determine associations between maternal demographics and breastfeeding for 6+ months with a significance threshold of P< 0.05.

Results: Mothers (n=14866) were predominantly White (n=4857, 44.83%), 25-29 years of age (n=4191, 29.50%), and English speaking (n=13270, 89.18%), with 13-15 years of education (n=4585, 31.62%) living in urban areas (n=11126, 83.27%) with an income of $20,001- $40,000 (n=4129, 31.38%, Table 1). Several findings from the regression were notable including mothers who were Alaska Native (AOR: 6.05, 95%CI 3.31-77.82), White Hispanic (AOR: 1.95, 95%CI 1.32-2.87), Multiracial (AOR: 2.00, 95%CI 1.26-3.17) and American Indian (AOR: 1.49, 95%CI 1.08-2.07) had greater odds of breastfeeding for six or more months compared to White, non-Hispanic mothers. Mothers who were Black (AOR: 0.65, 95%CI 0.52-0.83) had lower odds of breastfeeding for six or more months compared to White, non-Hispanic mothers. Additional contributing factors were noted for both income and maternal education (Table 2).

Conclusion: Our findings suggest maternal race/ethnicity, income, and education were all contributing factors to meeting the six-month recommendation. Continuing research is needed to evaluate influential factors within groups that may contribute to the increased breastfeeding rates such as community support and generational support.