Most African American Mothers Reject Breast-Feeding Advocacy


INDIANAPOLIS — Myths about the effects of breast-feeding, the promotion and availability of formula, and the absence of maternal role models are combining to thwart breast-feeding among urban African American women, Dr. Hari B. Srinivasan said during a poster presentation at the annual meeting of the Midwest Society for Pediatric Research.

In a study that mined data similar to those from a 2004 national survey by the Centers for Disease Control and Prevention, Dr. Srinivasan found that fewer than half of African American mothers initiate breast-feeding immediately following an in-hospital educational support program.

The study from Chicago's Sinai Children's Hospital revealed that among Hispanic and white mothers, the rate of breast-feeding initiation was 78% and 72%, respectively. The national goal is to have 75% of mothers initiate breast-feeding by 2010.

“This is a cultural issue. Breast-feeding education has to be started early in schools and in communities,” said Dr. Srinivasan, who is an assistant professor of pediatrics and an attending neonatologist at Sinai. He noted that if one generation chooses breast-feeding over formula, the next generation is more likely to follow suit.

“Also, the Women, Infants and Children program makes formula available to anyone who qualifies and who wants it free of cost. Although WIC is a good program, it serves as a disincentive to breast-feeding, especially among poorer populations. And every woman leaving the hospital after delivery gets a small bag from Ross Pharmaceuticals, and in that bag is a can of formula; so hospitals reinforce formula use,” Dr. Srinivasan said.

He pointed out that obstetricians serve as the first line of defense against formula use. “Obstetricians should get involved in educating patients about the benefits of breast-feeding early, during prenatal visits, and in the first 48 hours after delivery,” he said, adding that it's then up to pediatricians to pick up the ball.

In talking with his patients, Dr. Srinivasan discovered that many harbor negative myths, such as the myth that breast-feeding can cause a loss of breast contour and can slow weight loss after delivery.

“In actuality, women who breast-feed tend to return to their prepregnancy weights faster than those who don't,” he noted.

In this study, data on breast-feeding initiation rates for 3,324 infants were prospectively collected for a 1-year period. The overall breast-feeding initiation rate for the population was 68%.

Earlier this year, the Centers for Disease Control and Prevention reported that in 2004, 71.5% of non-Hispanic white children were ever breast-fed, compared with 50% of non-Hispanic black children. Among those who were ever breast-fed, 54% of white and 43% of black children continued breast-feeding until age 6 months (MMWR 2006;55:335–9).

“Strenuous public health efforts are needed to improve breast-feeding behaviors, particularly among black women and socially disadvantaged groups,” Dr. Srinivasan concluded.

'Strenuous public health efforts are needed to improve breast-feeding behaviors.' DR. SRINIVASAN

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