Medicaid and intention to breastfeed

Background: Wide disparities persist in breastfeeding rates among poor, less educated, and African American women. The role of public services like Medicaid in educating and encouraging pregnant women within underserved populations to initiate breastfeeding, a behavior linked with decreasing adverse infant outcomes, is instrumental. Yet, effects of these policies on improving rates of breastfeeding initiation are poorly investigated. This study aims to examine the association between receipt of Medicaid services and intention to breastfeed.

Methods: Pregnant women in their third trimester (N=100) were interviewed in an inner-city University Medical Center regarding their intent to initiate breastfeeding. The Infant Feeding Intention scale was used to assess intention to initiate and continue this behavior. Data on breastfeeding intent was dichotomized to represent “Low” vs. “High” intention. Logistic regression analyses were conducted to examine the relationship between Medicaid status and breastfeeding intent.

Results: The majority of pregnant women surveyed were African American (54%), unmarried (55%), and reported having less than college education (62%). Nearly two-thirds (61%) of Medicaid recipients had lower intent to breastfeed compared to 21% of women not receiving Medicaid services. After controlling for age, race, education and marital status, the odds of low intent to breastfeed was 4-fold higher among Medicaid recipients compared to non-Medicaid recipients.

Conclusion: Medicaid recipients have low intent to breastfeed during pregnancy. This study underscores the importance of cultivating partnerships with Medicaid and public service programs. These partnerships may serve as a conduit to target and educate pregnant women who have low intention to breastfeed.