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Birth. 2019 Dec 28. doi: 10.1111/birt.12477. [Epub ahead of print]

Maternal religion and breastfeeding intention and practice in the US Project Viva cohort.

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Centre for Research in Epidemiology and StatisticS (CRESS), Université de Paris, Inserm, Inrae, Paris, France.
Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA, USA.
MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Johannesburg, South Africa.
UMR 7206 Eco-anthropologie, CNRS, Musée de l'Homme, Paris, France.
Elfe unit, Inserm-Ined-EFS, Paris, France.
Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, QC, Canada.
Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.



Religion has rarely been studied as a determinant of infant feeding practices. We examined whether religious affiliation is associated with formula feeding vs breastfeeding intention and practice in women from the United States Project Viva cohort.


Between 1999 and 2002, 2128 pregnant women were recruited in the area of Boston, Massachusetts. They reported by questionnaire their religious affiliation, and their intended and practiced infant feeding mode (exclusive formula feeding vs partial vs exclusive breastfeeding) at different time points. We examined associations of religious affiliation with infant feeding intention and practice by modified Poisson regression and multinomial logistic regression adjusted for known sociodemographic confounders.


Of 1637 women with complete data, 52% reported being Catholic, 29% Protestant, 11% unaffiliated, 4% Jewish, and 4% other religion. Overall, 8.5% and 15.9% women intended and initiated exclusive formula feeding, respectively. Compared with unaffiliated women, Catholics were more at risk to intend to exclusively formula-feed their infant at birth (risk ratio [95% CI]: 6.4 [1.6-26.0]) and to exclusively formula-feed after delivery (2.4 [1.3-4.2]) and 3 months postpartum (1.3 [0.98-1.8]). The odds ratio for intending and practicing partial (vs exclusive) breastfeeding did not differ by religious affiliation at most examined time points. Associations of Protestant women with infant feeding exhibited estimates closer to unaffiliated than to Catholic women.


Catholic women are more at risk to intend and practice exclusive formula feeding than women of other religious affiliations. Our findings may help health care practitioners adapt their breastfeeding promotion to the mother's religious affiliation.


breastfeeding; christianity; infant formula; pregnancy; religion


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