Kelly Yvonne J, Watt Richard G, Nazroo James Y
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
Pediatrics. 2006 Nov;118(5):e1428-35. doi: 10.1542/peds.2006-0714.
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.
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 17,474 (96%) infants with complete data.
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 Caribbean, 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.
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 United Kingdom 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.
不同种族/族裔群体的母乳喂养模式差异很大；然而，对于可能解释不同种族/族裔群体之间及内部差异的因素知之甚少。在此，我们研究了种族/族裔多样化的初产妇样本中的母乳喂养启动和持续模式，并将其与美国的模式进行比较。评估了人口统计学、社会、经济和文化因素对母乳喂养行为中种族/族裔差异的影响。
样本包括其母亲参与了英国千禧队列研究首次调查的所有单胎婴儿。缺失数据使样本减少至17474名（96%）有完整数据的婴儿。
在对人口统计学、经济和心理社会因素进行调整后，逻辑回归模型显示，与白人母亲相比，印度、巴基斯坦、孟加拉国、加勒比黑人及非洲黑人母亲更有可能启动母乳喂养。对文化传统标志物进行进一步调整减弱了这些关系，但所有关系在统计学上仍具有显著性，这表明部分差异是文化因素造成的。在对人口统计学、经济和心理社会因素进行调整后，与白人母亲相比，印度、巴基斯坦、孟加拉国、加勒比黑人及非洲黑人母亲在3个月时更有可能持续母乳喂养。对文化传统标志物进行额外调整减弱了印度、巴基斯坦、孟加拉国及非洲黑人母亲之间的关系，但所有关系在统计学上仍具有显著性。针对4个月和6个月时母乳喂养持续情况运行的模型结果与此一致。
我们已经表明，在英国，母乳喂养率最高的是黑人和亚洲母亲，这与美国的模式形成鲜明对比，在美国，非西班牙裔黑人母亲的母乳喂养率最低。英国和美国母乳喂养的种族/族裔模式形成反差，这就需要采取截然不同的公共卫生方法来实现全国母乳喂养目标并减少健康差距。那些实施旨在提高母乳喂养率的未来政策的人需要关注所有种族/族裔群体不同的社会、经济和文化特征。
