Racial/Ethnic Differences in Breastfeeding Initiation and Continuation
in the United Kingdom and Comparison With Findings in the United
States
Full report at:
http://pediatrics.aappublications.org/cgi/content/full/118/5/e1428

OBJECTIVE. Patterns of breastfeeding vary considerably across
different racial/ethnic groups; however, little is known about factors
that might explain differences across and within different
racial/ethnic groups. Here we examine patterns of breastfeeding
initiation and continuation among a racially/ethnically diverse sample
of new mothers and compare this with patterns seen in the United
States. The effects of demographic, social, economic, and cultural
factors on racial/ethnic differences in breastfeeding practices are
assessed.

METHODS. The sample includes all singleton infants whose mothers
participated in the first survey of the United Kingdom Millennium
Cohort Study. Missing data reduced the sample to 17474 (96%) infants
with complete data.

RESULTS. After adjustment for demographic, economic, and psychosocial
factors, logistic regression models showed that Indian, Pakistani,
Bangladeshi, black Caribbean, and black African mothers were more
likely to initiate breastfeeding compared with white mothers. Further
adjustment for a marker of cultural tradition attenuated these
relationships, but all remained statistically significant, suggesting
that some of the difference was a consequence of cultural factors.
After adjustment for demographic, economic, and psychosocial factors,
Indian, Pakistani, Bangladeshi, black Carribbean, and black African
mothers were more likely to continue breastfeeding at 3 months
compared with white mothers. Additional adjustment for a marker of
cultural tradition attenuated the relationship for Indian, Pakistani,
Bangladeshi, and black African mothers, but all remained statistically
significant. Models run for breastfeeding continuation at 4 and 6
months were consistent with these results.

CONCLUSIONS. We have shown that in the United Kingdom the highest
breastfeeding rates are among black and Asian mothers, which is in
stark contrast to patterns in the United States, where the lowest rate
is seen among non-Hispanic black mothers. The contrasting
racial/ethnic patterns of breastfeeding in the UnitedKingdom and
United States necessitate very different public health approaches to
reach national targets on breastfeeding and reduce health disparities.
Those who implement future policies aimed at increasing breastfeeding
rates need to pay attention to different social, economic, and
cultural profiles of all racial/ethnic groups.

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