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ORIGINAL RESEARCH |
From the Departments of Obstetrics and Gynecology and Pediatrics, University of California, Los Angeles, CA (UCLA) School of Medicine; the Department of Community Health Sciences and the UCLA Breast-feeding Resource Program of the Center for Healthier Children, Families, and Communities, UCLA School of Public Health, Los Angeles, CA; and the Department of Economics, Occidental College, Los Angeles, CA.USA
Address reprint requests to: Michael C. Lu, MD, MS, MPH Department of Community Health Sciences University of California, Los Angeles School of Public Health Box 951772 Los Angeles, CA 90095-1772 E-mail: mclu{at}ucla.edu
Objective: To examine the influence of provider encouragement on breast-feeding among women of different social and ethnic backgrounds in the United States.
Methods: A nationally representative sample of 2017 parents with children younger than 3 years was surveyed by telephone. The responses of the 1229 women interviewed were included in the analysis. Respondents were asked to recall whether their physicians or nurses had encouraged or discouraged them from breast-feeding. The effects of provider encouragement on breast-feeding initiation and duration were evaluated by multivariate logistic regression. The sample was then stratified to allow subset analyses by race and ethnicity, education, income class, age group, and marital status.
Results: More than one-third (34.4%) of respondents did not initiate breast-feeding. Three-fourths (73.2%) of women reported having been encouraged by their physicians or nurses to breast-feed; 74.6% of women who were encouraged initiated breast-feeding, compared with only 43.2% of those who were not encouraged (P < 0.001). Women who were encouraged to breast-feed were more than four times (relative risk 4.39; 95% confidence interval 2.96, 6.49) as likely to initiate breast-feeding as women who did not receive encouragement. The influence of provider encouragement was significant across all strata of the sample. In populations traditionally less likely to breast-feed, provider encouragement significantly increased breast-feeding initiation, by more than threefold among low-income, young, and less-educated women; by nearly fivefold among black women; and by nearly 11-fold among single women.
Conclusion: Provider encouragement significantly increases breast-feeding initiation among American women of all social and ethnic backgrounds.
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