Department of Communication, University of North Dakota, Columbia Hall, Room 2370, 501 N Columbia Rd. Stop 7169, Grand Forks, ND, 58202-7169, USA.
Public Health Program, Department of Population Health, UND School of Medicine and Health Sciences, University of North Dakota, Room E162, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
Matern Child Health J. 2023 Jun;27(6):1070-1080. doi: 10.1007/s10995-023-03643-2. Epub 2023 Mar 29.
Despite Hispanics' high prevalence of breastfeeding compared to other racial/ethnic groups, contributing factors remain unclear. This study examines the complex relationship among Hispanic nativity, acculturation, income, and breastfeeding.
The Fragile Families Child Wellbeing Study baseline (1998-2000) and Year 1 data (1999-2001) were used, including 4,077 women (933 non-Hispanic white, 2,046 non-Hispanic Black, 352 US-born Mexicans [USM], 299 US-born other Hispanics [USH], 302 foreign-born Mexicans [FBM], and 145 foreign-born other Hispanics [FBH]). Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for associations between Hispanic nativity and breastfeeding initiation and 4-month and 6-month breastfeeding, accounting for acculturation (Spanish language use, cultural engagement, religiosity, and traditional gender role attitudes), demographics, income, and health factors. Models were run for the overall sample and stratified by low vs. high income (above median: $21,600).
FBM(OR:2.35, 95%CI 1.33,4.15) and FBH(OR:2.28, 95%CI 1.23,4.24) had higher odds, while USM(OR:0.55, 95%CI 0.41,0.73) and USH(OR:0.50, 95%CI 0.37,0.67) had lower odds of breastfeeding initiation, compared to white women. USM had lower odds of 4-month(OR:0.53, 95%CI 0.36,0.80) and 6-month breastfeeding(OR:0.38, 95%CI 0.23,0.63), as did USH for 4-month(OR:0.64, 95%CI 0.42,0.99) and 6-month breastfeeding(OR:0.50, 95%CI 0.30,0.85). In stratified models, low-income (vs. high-income) FBH had higher odds of breastfeeding initiation(OR:3.73 95%CI 1.43,9.75) and 4-month(OR:3.01 95%CI 1.12,8.04) and 6-month breastfeeding(OR:3.08 95%CI 1.07,8.88), yet effects of acculturation across income strata are inconsistent.
The Hispanic paradox operates differentially due to nativity, income, and acculturation. Breastfeeding intervention and promotion may require tailored approaches to Hispanic subgroups.
尽管与其他种族/族裔群体相比，西班牙裔的母乳喂养率较高，但促成因素仍不清楚。本研究考察了西班牙裔原籍国、文化适应、收入和母乳喂养之间的复杂关系。
使用脆弱家庭和儿童福利研究基线（1998-2000 年）和第 1 年数据（1999-2001 年），包括 4077 名妇女（933 名非西班牙裔白人、2046 名非西班牙裔黑人、352 名美国出生的墨西哥人 [USM]、299 名美国出生的其他西班牙裔人 [USH]、302 名外国出生的墨西哥人 [FBM]和 145 名外国出生的其他西班牙裔人 [FBH]）。使用逻辑回归估计了西班牙裔原籍国与母乳喂养开始以及 4 个月和 6 个月母乳喂养之间的关联的优势比（OR）和 95%置信区间（CI），并考虑了文化适应（西班牙语使用、文化参与、宗教信仰和传统性别角色态度）、人口统计学、收入和健康因素。为整个样本和高低收入分层（中位数以上：$21,600）运行了模型。
与白人女性相比，FBM（OR：2.35，95%CI 1.33,4.15）和 FBH（OR：2.28，95%CI 1.23,4.24）的几率更高，而 USM（OR：0.55，95%CI 0.41,0.73）和 USH（OR：0.50，95%CI 0.37,0.67）的母乳喂养几率较低。USM 的 4 个月（OR：0.53，95%CI 0.36,0.80）和 6 个月（OR：0.38，95%CI 0.23,0.63）母乳喂养的几率较低，而 USH 的 4 个月（OR：0.64，95%CI 0.42,0.99）和 6 个月（OR：0.50，95%CI 0.30,0.85）母乳喂养的几率也较低。在分层模型中，低（高）收入（VS. 高收入）FBH 的母乳喂养开始（OR：3.73，95%CI 1.43,9.75）和 4 个月（OR：3.01，95%CI 1.12,8.04）和 6 个月（OR：3.08，95%CI 1.07,8.88）的几率更高，但收入阶层的文化适应的影响不一致。
西班牙裔的悖论由于原籍国、收入和文化适应而存在差异。母乳喂养干预和促进可能需要针对西班牙裔亚群采取有针对性的方法。
