Racial and Educational Factors Associated with Breast-
Feeding -- United States, 1969 and 1980
According to 1969 and 1980 National Natality Surveys (NNS) of
postpartum women conducted by the National Center for Health
Statistics, a significantly higher percentage of both black and
white
women exclusively breast-fed their infants in 1980 than in 1969
(Figure 1).
At 3-6 months postpartum, NNS questionnaires were mailed to a
probability sample of mothers of live infants born in wedlock
during
the respective years.* Eighty-five percent of the 3,666 mothers of
selected newborns responded in 1969, while 80% of the 7,825 mothers
of
selected newborns responded in 1980. Responses were weighted to
reflect national estimates of live infants born in wedlock in the
United States during each year.
Nineteen percent of white women exclusively breast-fed newborns
in
1969, compared with a significantly higher percentage (51%) in
1980.
Nine percent of black women exclusively breast-fed newborns in
1969,
compared with a significantly higher percentage (25%) in 1980. The
percentage of both black and white women who exclusively bottle-fed
was correspondingly lower in 1980 than in 1969. The percentage of
women who mixed breast- and bottle-feeding did not differ
appreciably
in 1969 and 1980 in either racial group.
Among white women in 1969, breast-feeding significantly
declined
with parity from the first to sixth child and increased slightly
thereafter. In contrast, among black women, significantly more
breast-feeding of newborns in 1969 occurred among women with four
children or more. In 1980, significantly more white primiparae
than
multiparae breast-fed. Among white multiparae, there was a slight
but
not significant decline in the percentage of breast-feeding with
increasing parity. A similar decline was evident among black women
in
1980; these differences, however, were not significant.
Among white women, a significantly higher percentage of
breast-feeding was observed with increasing maternal education in
1969, as well as in 1980. In sharp contrast, among black women
with
newborns in 1969, there was a significant decrease in
breast-feeding
as the educational level of the mother increased. However, in
1980, a
relationship similar to that observed in whites appeared.
The differences by race persist when education and parity are
controlled for.
Reported by K Fetterly, B Graubard, MS, Epidemiology and Biometry
Research Program, National Institute of Child Health and Human
Development; Natality Statistics Br, National Center for Health
Statistics; Div of Nutrition, Center for Health Promotion and
Education, CDC.
Editorial Note
Editorial Note: Estimates of breast-feeding in the NNS were based
only on respondent data weighted to reflect the national
distribution
of live births to married women. Since the NNS breast-feeding
estimates were not adjusted for nonresponse, and nonrespondents
tend
to be from the lower socioeconomic group, the estimate of
breast-feeding among the less educated may be inaccurate. The NNS
exclude births to unwed mothers, and out-of-wedlock births occur
more
frequently among the disadvantaged. To the extent that
breast-feeding
has positive health effects, the lower socioeconomic group with its
high rates of infant morbidity and mortality can be expected to
benefit the most. More information is needed about their
infant-feeding practices to identify target groups for
breast-feeding
promotion efforts.
*The 1969 sample was selected from one in every 1,000 births of
white
infants and one in every 500 births of all other infants. The 1980
sample was selected from one in 400 liveborn infants weighing 2,500
g
or more and one in 95 liveborn infants weighing under 2,500 g.
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