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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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