Race, body mass index and breastfeeding outcomes among black and white mothers

The purpose of this study is to examine the association between race, body mass index and breastfeeding outcomes among black and white women in Mississippi. A secondary analysis from of the 2009 – 2011 Mississippi Pregnancy Risk Assessment Monitoring System was conducted. Multivariable hazard ratios were investigated to assess the relationship between marital status and breastfeeding duration at 8 weeks postpartum. Stratified analyses were performed for white and black women. In terms of breastfeeding initiation and race, black women (63.1%) had a higher percentage of not initiating breastfeeding than white women (36.6%). The Chi-Square results, χ²(1) = 105.872 (p<0.001), indicating that there was a statistically significant association between race and breastfeeding initiation. Overall, both black and white women included in the study breastfed for approximately 3.08 weeks postpartum. Black women breastfeed for an average of 2.61 weeks compared to white women who breastfed for 3.62 week. At 8 weeks postpartum, the estimated probability of breastfeeding among white mothers was statistically different than white women. For body mass index, the results showed that there was no statistically significant association between BMI and breastfeeding initiation (p = 0.122). The Kaplan Meier analysis indicated that at 8 weeks postpartum, there was a statistically significant difference in breastfeeding duration within the BMI groups. However, after adjusting for confounding factors using the Cox regression the results indicated that BMI was not a predictor for breastfeeding duration. The results obtained from this study showed that 18.4%, 29.3%, 27.9%, and 25.7% of women underweight, obese, overweight, and normal BMI group, respectively, were breastfeeding at 8 weeks. There was a statistically significant difference between the BMI groups in breastfeeding duration (p<0/05). The survival curve showed that the probability of continuing breastfeeding was lower for underweight women than all of the other age groups at all time points. The overall average of weeks in which mothers continued to breastfeed for each corresponding age group was 3.094 weeks followed by 2.36, 3.19, 3.15, and 3.05; respectively for each BMI category. The results for BMI showed that the breastfeeding rate at 8 weeks postpartum was statistically different among each weight group (p<0.005). After adjusting for the following covariates: race, age, education, income, marital status, prenatal education, WIC participation and postpartum education (Cox Regression), the results showed that women were no more likely to continue breastfeeding at 8 weeks based on BMI (underweight, normal, overweight and obese).