title: Characteristics associated with breastfeeding behaviors among urban versus rural women enrolled in the Kansas WIC program.
abstract: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a public nutritional assistance program for low-income women and their children up to age five. This study provides insight into maternal characteristics associated with breastfeeding among urban versus rural women. A secondary analysis was conducted using the Pregnancy Nutrition Surveillance System dataset of women enrolled in the Kansas WIC program in 2011. Geographic residency status was obtained through application of the Census tract-based rural-urban commuting area codes. Descriptive variables included maternal demographics, health, and lifestyle behaviors. A multivariable binary logistic regression was used to obtain adjusted odds ratios with 95 % confidence intervals. The outcome variable was initiation of breastfeeding. A P value of ≤0.05 was considered statistically significant. The total sample size was 17,067 women. Statistically significant differences regarding socio-demographics, program participation, and health behaviors for urban and rural WIC participants were observed. About 74 % of all WIC mothers initiated breastfeeding. Urban women who were Hispanic, aged 18-19, high school graduates, household income >$10,000/year, and started early prenatal care were more likely to breastfeed. Urban and rural women who were non-Hispanic black with some high school education were less likely to breastfeed. Increased breastfeeding initiation rates are the result of a collaborative effort between WIC and community organizations. Availability of prenatal services to rural women is critical in the success of breastfeeding promotion. Findings help inform WIC program administrators and assist in enhancing breastfeeding services to the Kansas WIC population.
authors.affiliation: Department of Preventive Medicine and Public Health, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA, ljacobson@kumc.edu.
authors.forename: Lisette T
authors.initials: LT
authors.lastname: Jacobson
authors.forename: Philip
authors.initials: P
authors.lastname: Twumasi-Ankrah
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Redmond
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ablah
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hines
authors.forename: Judy
authors.initials: J
authors.lastname: Johnston
authors.forename: Tracie C
authors.initials: TC
authors.lastname: Collins
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D063105:Food Assistance / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007223:Infant; D000068104:Infant Health / Q000706:statistics & numerical data; D007231:Infant, Newborn; D007615:Kansas / Q000453:epidemiology; D000068097:Maternal Health / Q000706:statistics & numerical data; D011247:Pregnancy; D044469:Racial Groups / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult