Breastfeeding

Narrative

Breastfeeding has been shown to promote the health and development of infants, as well as their immunity to disease. It also confers a number of maternal health benefits, such as a decreased risk of breast and ovarian cancers and other chronic conditions, including cardiovascular disease.1, 2 The American Academy of Pediatrics Section on Breastfeeding recommends exclusive breastfeeding—with no supplemental food or liquids—through the first 6 months of life and continued breastfeeding through at least the first year.3 One study indicated that suboptimal breastfeeding rates in the United States add an estimated $2.2 billion dollars annually to direct medical costs.4

While three-quarters of infants born in 2010 were ever breastfed (76.5 percent), slightly less than half (49.0 percent) were fed breast milk for the first 6 months of life, and 16.4 percent were exclusively breastfed for that duration. Breastfeeding practices vary considerably by maternal race and ethnicity, age, and education. With respect to race and ethnicity, the proportion of infants to have ever been breastfed was higher among Asian, Hispanic, and non-Hispanic White infants (84.8, 77.9, and 78.8 percent, respectively) than non-Hispanic Black infants (61.9 percent; Figure 1).

breastfed infants by race

Figure 1 Source

Infants born to mothers aged 30 years or older were most likely to have been breastfed (80.9 percent), while children born to mothers under 20 years of age were least likely to have ever been breastfed (51.3 percent; Figure 2). Similarly, 17.9 percent of infants born to mothers aged 30 years or older breastfed exclusively at 6 months, compared to 5.8 percent of infants born to mothers younger than age 20.

breastfed infants by maternal age

Figure 2 Source

With regard to maternal education, the proportion of infants to have ever been breastfed and to have been breastfed exclusively at 6 months was highest among those born to mothers with at least a college education (88.7 and 21.8 percent, respectively). Common barriers to exclusive breastfeeding include maternal employment, pain related to breastfeeding, and unsupportive hospital policies.5 The Affordable Care Act requires most health insurance plans to provide breastfeeding support, counseling, and equipment to pregnant and nursing women.6

Data Sources

Figure 1. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. National Immunization Survey (NIS). Unpublished data. The 2010 provisional rates are based on the landline telephone sample in NIS to maintain comparability with previous years in the decade when only a landline sample was available.

Figure 2. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. National Immunization Survey (NIS). Unpublished data. The 2010 provisional rates are based on the landline telephone sample in NIS to maintain comparability with previous years in the decade when only a landline sample was available.

Endnotes

1 Ip S, Chung M, Raman G, Chew P, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment. April 2007;153:1–186.

2 Schwarz EB, Ray RM, Steube AM, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstetrics and Gynecology. 2009;113(5):974–982.

3 Gartner LM, Morton J, Lawrence RA, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115(2):496–506.

4 Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048–e1056.

5 Office of the Surgeon General; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; U.S. Department of Health and Human Services, Office on Women’s Health. Barriers to breastfeeding in the United States. The Surgeon General’s Call to Action to Support Breastfeeding. Rockville (MD): Office of the Surgeon General; 2011. Accessed August 20, 2014.

6 U.S. Department of Health and Human Services, Health Resources and Services Administration. Women’s Preventive Services Guidelines. Accessed August 20, 2014.

Data

Statistical Significance Test

Calculate the difference between two estimates:

Calculated Z-Test Result 0.9567433 Not statistically significant

We follow statistical conventions in defining a significant difference by a p-value less than 0.05 where there is a less than 5% probability of observing a difference of that magnitude or greater by chance alone if there were really no difference between estimates. The 95% confidence interval includes a plausible range of values for the observed difference; 95% of random samples would include the true difference with fewer than 5% of random samples failing to capture the true difference.

This website allows comparisons between two estimates using the independent z-test for differences in rates or proportions. This test is appropriate for comparing independent populations across years (e.g., 2011 versus 2012) or subgroups (e.g., Male versus Female) on corresponding measures. To the extent possible, the functionality of this application has limited estimate comparisons based on appropriate use of the independent z-test. However, some tables present subgroup categories within broader categories that will allow comparisons between non-independent populations (e.g., low birth weight and very low birth weight). Users should exercise caution when interpreting these test results, which will frequently overstate statistical significance.

For some tables, the website does not allow for comparisons between two estimates, even though the data represent independent populations. Generally, this is because the standard errors were not publicly available at the time this website was created.

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