Recorded presentation

Nicole B Neault, BA¹, Deborah A Frank, MD¹, Barbara L. Philipp, MD, IBCLC², Anne Merewood, MA, IBCLC², Suzette Levenson, MPH, MEd³, Timothy Heeren, PhD⁴, John T. Cook, PhD², Alan Meyers, MD, MPH⁵, Patrick Casey, MD⁶, Diana B Cutts, MD⁷, Maureen Black, PhD⁸, Nieves Zaldivar, MD⁹, and Carol Berkowitz, MD¹⁰. (1) Department of Pediatrics, Boston Medical Center, 820 Harrison Avenue, FGH-3, Boston, MA 02118, 617-638-5850, nneault@bu.edu, (2) Division of General Pediatrics, Boston University School of Medicine, Maternity Building, 4th Floor, 91 East Concord Street, Boston, MA 02118, (3) Data Coordinating Cener, Boston University School of Public Health, 715 Albany Street, 580 Building, Boston, MA 02118, (4) Department of Epidemiology and Biostatistics, Boston University School of Public Health, 715 Albany Street, TE330, Boston, MA 02118, (5) Division of General Pediatrics, Boston Medical Center, 91 East Concord Street, Mat.Bldg., Rm 411, Boston, MA 02118, (6) Department of Pediatrics, University of Arkansas for Medical Sciences, 800 Marshall Street, Little Rock, AR 72202, (7) Department of Pediatrics, Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN 55415, (8) Department of Pediatrics, University of Maryland School of Medicine, 655 W. Lombard Street, Suite 311, Baltimore, MD 21201, (9) Mary's Center for Maternal and Child Care, 2333 Ontario Road, NW, Washington, DC 20009, (10) Harbor-UCLA Medical Center, 1000 W. Carson Street, Bin 437, Torrance, CA 90509

Background: Immigrants are disproportionately affected by food insecurity (FI), putting their children at risk for the health consequences of not having access to nutritionally adequate and safe foods. Objective: To evaluate the impact of breastfeeding on child FI and health outcomes among an immigrant population. Design/Methods: From 9/98-6/03, as part of the Children’s Sentinel Nutritional Assessment Program (C-SNAP), a convenience sample of 2,847 immigrant caregivers and 4,280 US born caregivers with children 0-1 year of age were interviewed in emergency departments/pediatric clinics in 6 sites (AR, CA, DC, MA, MD, MN). Caregivers indicated whether the child was ever or currently breastfed, breastfeeding duration, child health history, household demographics, and FI (measured by the USDA Food Security Scale). Bivariate analyses identified confounders associated with breastfeeding and outcomes, which were controlled in logistic regression. Results: 79% of infants of immigrants (compared to 38% of infants of US born caregivers) were reported to be breastfed for at least two weeks. The immigrant sample characteristics included: 67% Hispanic; 28% Black, not Hispanic; 35% household FI; and 22% child FI. After controlling for study site, race/ethnicity, and child low birthweight, breastfed infants of immigrants were more likely to be in households with perceived child FI (AOR: 1.31, CI: 1.02,1.68, p=.03). However, these infants were less likely to be reported in fair/poor health (AOR: 0.67, CI: 0.52,0.87, p=.002), less likely to have a chronic health problem (AOR: 0.65, CI: 0.42,0.98, p=.04), and less likely to have previous hospitalizations (AOR: 0.71, CI: 0.56,0.91, p=.006). In the sample of US born caregivers, no significant relationships were found between breastfeeding and child FI or health outcomes. Conclusions: Breastfeeding is associated with improved health outcomes in this immigrant population, despite breastfed infants being in households with more child food insecurity. Breastfeeding is an adaptive strategy in the first year of life to improve all infants’ health, especially for children of immigrants who are more likely to experience food insecurity.

Learning Objectives:

• Recognize the association between breastfeeding, food security and health outcomes in an immigrant population.

Keywords: Breast Feeding, Immigrants

Related Web page: dcc2.bumc.bu.edu/csnappublic/home.html

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.

Recorded presentation