The decision to breastfeed in the United States: does race matter?
OBJECTIVE
To estimate the effects of maternal and birth characteristics on the decision to breastfeed and to relate breastfeeding practices to racial differences in infant mortality.


METHODS
Using a sample of women with young children from the National Survey of Family Growth (NSFG), Cycle V, 1995, the likelihood of breastfeeding was modeled using logistic regression techniques. In addition, single, live births from the NSFG 1988 and 1995 surveys were analyzed to model the effects of race and breastfeeding on infant mortality using Cox regression methods.


RESULTS
After controlling for socioeconomic background and birth characteristics, race remained a strong predictor of breastfeeding. Black women were less likely to breastfeed than nonblack women were, and the primary reason indicated by black women for not breastfeeding was that they "preferred to bottle-feed." Analyses of infant mortality indicated that breastfeeding accounts for the race difference in infant mortality in the United States at least as well as low birth weight does.


CONCLUSIONS
Race is an important predictor of breastfeeding, with most black women reporting that they "preferred bottle-feeding." Efforts to increase breastfeeding of infants in the black community should help narrow the racial gap in infant mortality.
Forste
R
R
Department of Sociology, Brigham Young University, Provo, Utah 84602, USA. renata_forste@byu.edu
Weiss
J
J
Lippincott
E
E
D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D001903:Bottle Feeding / Q000523:psychology / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D003657:Decision Making; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D007226:Infant Mortality; D007227:Infant Nutritional Physiological Phenomena; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D017533:Marital Status / Q000706:statistics & numerical data; D011336:Probability; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data