Trends and correlates of breastfeeding in North Carolina : results from the North Carolina pregnancy risk assessment monitoring system (PRAMS), 1997-2001

North Carolina Public Health www.schs.state.nc.us/SCHS/ No. 142 June 2004 Trends and Correlates of Breastfeeding in North Carolina: Results from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) 1997-2001 by Paige Hall Smith, PhD* Matt Avery, MA Ziya Gizlice, PhD ABSTRACT Objectives: Infants who are primarily breastfed have been shown to have fewer episodes of infections such as otitis media, upper respiratory infection, and gastrointestinal disorders. Breastfeeding has been shown to reduce illness, saving health care dollars. This study examines breastfeeding trends over time and identifies demographic, maternal, infant, and environmental factors associated with initiation of breastfeeding and duration over eight weeks. Methods: Survey data from the Pregnancy Risk Assessment Monitoring System (PRAMS) were used for this study. This consists of a random sample of 7,935 live births for the period 1997-2001. Results: Overall, 64 percent of women reported initiating breastfeeding; 65 percent of those women continued to breastfeed at eight weeks. This study found that women who have lower income and less education, are unmarried, obese, depressed, or who smoke are less likely to breastfeed. Hispanic women are more likely to breastfeed and to continue to breastfeed at eight weeks, compared to white non-Hispanic women. Women who engage in other healthy behaviors such as taking a multivitamin containing folic acid and not smoking have higher rates of breastfeeding. Conclusions: While North Carolina has seen a substantial increase in breastfeeding initiation from 1997 (58.8%) to 2001 (67.5%), this is still below the National Healthy People 2010 goal of 75 percent. By eight weeks only about 40 percent of women were still breastfeeding at all, lower than the Healthy People 2010 goal of having 50 percent still breastfeeding at six months. Health care providers should educate women of childbearing age on the health benefits of breastfeeding, and should specifically target at-risk groups of women such as those who are overweight, unmanned, depressed after giving birth, or have a high school degree or less. *Paige Hall Smilh is Director of the Center for Women’s Health and Wellness of the School of Health and Human Performance at the University of North Carolina at Greensboro and Linda Carlisle Professor of Women’s and Gender Studies. NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES