Women's status, breastfeeding infrastructure, and breastfeeding outcomes: A state level analysis

Breastfeeding support efforts have addressed multiple levels of influence that affect breastfeeding rates. Interventions have been aimed at creating support for breastfeeding not only at the individual level, but also at community, organizational, and policy levels. Recent theoretical and empirical research suggests the status of women (SOW) may be associated with breastfeeding rates. We conducted a state level analysis of the association between the SOW, breastfeeding infrastructure and support, and breastfeeding initiation, duration (6 and 12 mos), and exclusivity (3 and 6 mos). Breastfeeding outcome measures and composite indicators of breastfeeding support (birth facility/professional support) and structure (state health department FTE, BF coalition, child care regulation and legislation) come from the Centers for Disease Control and Prevention's annual Breastfeeding Report Card. Composite measures of the SOW included 4 widely recognized domains of women's status: political participation; reproductive rights; employment and earnings; and social and economic autonomy; for many analyses we combined the last two domains as they were highly correlated. Using SPSS bivariate analysis indicated that breastfeeding support was significantly associated with all 5 breastfeeding outcomes whereas breastfeeding structure was not associated with any; all of the domains of SOW were associated with most of the breastfeeding outcomes. Multivariate analyses indicated that breastfeeding support and women's economic and social status were the best predictors across the five outcomes. This presentation will discuss what these and additional findings suggest about how breastfeeding and breastfeeding support are connected to the status of women and implications for future research, practice and policy.