The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #60416

Charles E. Denk, Ph D, Maternal and Child Health Epidemiology, New Jersey Department of Health and Senior Services, P.O. Box 364, Trenton, NJ 08625-0364, Lakota K. Kruse, MD, MPH, Division of Family Health Services, New Jersey Department of Health and Senior Services, P O Box 364, Office of the Medical Director, Trenton, NJ 08625, (609) 292-5656, lkruse@doh.state.nj.us, and Florence Rotondo, IBCLC, WIC Program, Division of Family Health Services, New Jersey Department of Health and Senior Services, P O Box 364, Trenton, NJ 08625.

Breastfeeding has important beneficial health effects for newborns. Exclusive breastfeeding at hospital discharge (BFED) is an important indicator of sustained breastfeeding through the first year of life. We find considerable volatility in breastfeeding status at discharge between the first and second birth in a longitudinally linked maternal file capturing New Jersey births from 1996-2001. Among mothers who breastfed exclusively after the first birth, only two thirds did so in the second (retention). Among mothers who exclusively formula fed at the first birth, one quarter breastfed exclusively or supplemented breastfeeding with formula feeding after the second birth (recruitment). Net change between the first and second birth for these mothers was a decline from 53 to 47 percent in exclusive breastfeeding, and an increase from 32 to 36 percent in exclusive formula feeding. Among mothers who supplemented breastfeeding with formula feeding after the first birth, more than a third exclusively breastfed after the second birth. We conclude that breastfeeding initiation is not only a matter of socio-cultural preferences; retention of exclusive breastfeeding across births is problematic, and opportunities for recruitment to exclusive breastfeeding after later births can be exploited. Strategies to promote breastfeeding should recognize the dynamic interplay of intention and realization, and develop situationally specific interventions.

Learning Objectives:

Audience will understand that:
• Breastfeeding status at discharge is variable from first to second birth. Mothers transition from exclusive breastfeeding to formula feeding, in both directions, with substantial frequency.
• Aggregate rates of exclusive breastfeeding by parity depend on the relative rates of these transitions.
• The interplay between socio-cultural (demographic) predisposition toward breastfeeding and the unfolding post-partum context is complex, but can inform clinical intervention.

Keywords: Breastfeeding, MCH Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.