Increasing breastfeeding rates: do changing demographics explain them?

OBJECTIVES

This study examines whether increases in breastfeeding rates between 1991 and 2002 can be attributed to changes in the demographic characteristics of births. The demographic variables investigated include maternal age, maternal education, race/ethnicity, geographic location of birth, and parity.

METHODS

This study decomposes breastfeeding trends using 1991 through 2002 data from the Ross Laboratories Mothers Survey and birth certificates.

RESULTS

Changing birth compositions by maternal age and education explain 9.8% and 11.5% of the increase in breastfeeding initiation rates, respectively. Changing birth compositions by maternal age and education explain 10.2% and 9.0% of increasing breastfeeding rates 6 months after birth, respectively. If changes in the composition of births by race/ethnicity had not occurred, breastfeeding rates would have increased more. Changes in the composition of births by geographic location of birth and parity do not explain any of the increase in breastfeeding rates.

CONCLUSIONS

Overall, changes in the demographic characteristics of births explain up to approximately 20% of the increasing trends in initial breastfeeding rates and breastfeeding rates 6 months after birth. Although this is a significant amount, it is important to continue investigating which additional factors explain recent breastfeeding increases such as changes in laws and policies, health promotion, the Special Supplemental Program for Women, Infants, and Children, employer support, technological innovation, and attitudes toward breastfeeding.