Breastfeeding Rates Vary by Race, Region

Breastfeeding Rates Lag Among African-Americans Living in the Southeast, CDC Says

Reviewed by Laura J. Martin, MD on March 25, 2010

March 25, 2010 -- Breastfeeding rates in the U.S. not only vary by race and ethnicity, but geography also plays a role.

Nationwide, 54.4% of African-American mothers, 74.3% white mothers, and 80.4% of Hispanic mothers attempted to breastfeed, according to a CDC telephone survey. But the numbers shift widely based on region.

Breastfeeding rates lagged most for African-American mothers living in the Southeast. CDC researchers found that in 13 states, primarily in the Southeast, African-American mothers had breastfeeding initiation rates at least 20% lower than white mothers. In six states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, and South Carolina), the prevalence of initiating breastfeeding among African-American women was less than 45%.

In Western states, Hispanic mothers had a higher prevalence than white mothers of initiating breastfeeding. In Eastern states, white mothers had a higher prevalence.

The findings are based on a telephone survey to households with children born between 2003 and 2006. The survey shows that national estimates for breastfeeding -- from initiation to six months to one year -- were 73.4%, 41.7%, and 21%, respectively.

Researchers reported their findings in the March 26 issue of Morbidity and Mortality Weekly Report, a publication of the CDC.

National Goals for Breastfeeding

Breastfeeding rates have improved in the past 25 years, when federal health authorities began to publicly advocate for increased breastfeeding. In 1984, nationwide, 65% of white mothers and 33% of African-American mothers initiated breastfeeding; by 2005, that gap had narrowed to 77% of white mothers and 61% of African-American mothers.

Overall, the CDC found that most states fell short of meeting the Healthy People 2010 targets for breastfeeding. Healthy People 2010 is a federal program designed to improve the overall health of children and adults in the U.S. The program's goals for initiating breastfeeding, continuing breastfeeding to age 6 months, and breastfeeding to age 1 year were 75%, 50%, and 25%, respectively.

CDC researchers reported that several factors can contribute to lower breastfeeding rates, including the mother being young and undereducated, lower income, being unmarried, and participating in the federal Women, Infants, and Children supplemental nutrition program. Cultural differences may also play a role.

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life and continued breastfeeding until the child's first birthday. Breastfeeding is strongly encouraged because breast milk contains many antibodies not found in commercial infant formulas that help protect infants from disease. Breastfeeding has been associated with a reduced risk of several chronic diseases among children, including obesity, asthma, and type 2 diabetes. There are also health benefits to the mother, including a lowered risk of type 2 diabetes, breast and ovarian cancer, and postpartum depression.

"Breastfeeding provides a wide range of benefits to the mother, child, and community, and reaching a higher prevalence of infant breastfeeding is an important public health goal," the CDC researchers write. "To continue to work toward reducing racial/ethnic disparities in breastfeeding, CDC is reassessing strategies for promoting and supporting breastfeeding among non-Hispanic black women."

Show Sources


Morbidity and Mortality Weekly Report, March 26, 2010; vol 59: pp 327-334.

American Academy of Pediatrics.

Grummer-Strawn, L.M. Breastfeeding Medicine, 2009; vol 4: pp S31–S39.

Department of Health and Human Services: "Benefits of Breastfeeding."

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