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Am J Public Health. 2008 Oct;98(10):1872-80. doi: 10.2105/AJPH.2007.127118. Epub 2008 Aug 13.

Multivariate analysis of state variation in breastfeeding rates in the United States.

Author information

  • 1Health Resources and Services Administration, Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, USA. mkogan@hrsa.gov

Abstract

OBJECTIVES:

We sought to determine the impact of sociodemographic and behavioral factors and state legislation on breastfeeding initiation (child ever fed breastmilk) and duration.

METHODS:

We used data from a nationally representative study of children aged 6 to 71 months (N = 33 121); we calculated unadjusted and adjusted state estimates for breastfeeding initiation and duration. We used logistic regression models to examine factors associated with never breastfeeding or breastfeeding less than 6 months. We conducted a multilevel analysis of state legislation's role.

RESULTS:

There were wide state variations in breastfeeding initiation and duration. The western and northwestern states had the highest rates. Covariate adjustment accounted for 25% to 30% of the disparity. Multivariate analysis showed that the adjusted odds of not being breastfed were 2.5- to 5.15-times greater in southern states compared with Oregon (reference). Children in states without breastfeeding legislation had higher odds of not being breastfed.

CONCLUSIONS:

Sociodemographic and maternal factors do not account for most breastfeeding rate variation. The association with breastfeeding legislation should be explored and may reflect cultural norms.

PMID:
18703441
[PubMed - indexed for MEDLINE]
PMCID:
PMC2636475
Free PMC Article
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