Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003
Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003
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DOI：
10.1542/peds.2006-2089g
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发表时间：
2007-02-01
期刊：
影响因子：
8
通讯作者：
Dee, Deborah L.
中科院分区：
文献类型：
--
作者：
Singh, Gopal K.;Kogan, Michael D.;Dee, Deborah L.
目标.以前的研究表明，美国母乳喂养的开始和持续时间率存在巨大的种族/民族和社会经济差异。然而，移民身份在理解这种差异方面的作用还没有得到很好的研究。在这项研究中，我们检查了母乳喂养的开始和持续时间的程度不同的移民身份的整体和结合种族/民族和社会经济地位后，控制其他相关的社会和行为的协变量。使用2003年全国儿童健康调查的33121名0至5岁儿童的横截面数据，按社会因素计算了3个月、6个月和12个月的母乳喂养率和持续时间率。采用多因素logistic回归分析来估计6个月和12个月时从未母乳喂养和未母乳喂养的相对几率。超过72%的母亲报告曾母乳喂养婴儿，持续率在3个月，6个月和12个月分别下降到52%，38%和16%。在这项分析中包括的12个种族移民群体中，母乳喂养率差异很大，从与土著父母一起生活的土著黑人儿童的48%到移民黑人和白色儿童的88%。与父母在外国出生的移民西班牙裔儿童（文化适应度最低的群体）相比，父母为西班牙裔、白色、黑人和其他种族的本地儿童（文化适应度最高的群体）从未母乳喂养的几率分别高出2.4、2.9、6.5和2.4倍。社会经济模式也因移民身份而异，6个月时母乳喂养的差异更大。每个种族/族裔群体中的移民妇女比土著妇女有更高的母乳喂养开始率和更长的持续时间。文化适应与西班牙裔和非西班牙裔妇女的母乳喂养率较低有关。母乳喂养率较低的种族移民和社会群体可以成为母乳喂养促进计划的目标。
Objectives. Previous research has shown substantial racial/ethnic and socioeconomic disparities in US breastfeeding initiation and duration rates. However, the role of immigrant status in understanding such disparities has not been well studied. In this study we examined the extent to which breastfeeding initiation and duration varied by immigrant status overall and in conjunction with race/ethnicity and socioeconomic status after controlling for other relevant social and behavioral covariates.Methods. The cross-sectional data for 33 121 children aged 0 to 5 years from the 2003 National Survey of Children's Health were used to calculate ever-breastfeeding rates and duration rates at 3, 6, and 12 months by social factors. Multivariate logistic regression was used to estimate relative odds of never breastfeeding and not breastfeeding at 6 and 12 months.Results. More than 72% of mothers reported ever breastfeeding their infants, with the duration rate declining to 52%, 38%, and 16% at 3, 6, and 12 months, respectively. Ever-breastfeeding rates varied greatly among the 12 ethnic-immigrant groups included in this analysis, from a low of 48% for native black children with native parents to a high of 88% among immigrant black and white children. Compared with immigrant Hispanic children with foreign-born parents (the least acculturated group), the odds of never breastfeeding were respectively 2.4, 2.9, 6.5, and 2.4 times higher for native children with native parents (the most acculturated group) of Hispanic, white, black, and other ethnicities. Socioeconomic patterns also varied by immigrant status, and differentials were greater in breastfeeding at 6 months.Conclusions. Immigrant women in each racial/ethnic group had higher breastfeeding initiation and longer duration rates than native women. Acculturation was associated with lower breastfeeding rates among both Hispanic and non-Hispanic women. Ethnic-immigrant and social groups with lower breastfeeding rates identified herein could be targeted for breastfeeding promotion programs.