Publication year
2015
Citation Title
Do black-white racial disparities in breastfeeding persist in the military community?
Journal Name
Maternal and Child Health Journal
Journal Volume
19
Issue Number
2
Page Numbers
419-427
DOI
10.1007/s10995-014-1524-x
Summary
There are many well-known health benefits of breastfeeding for mothers and infants. This study examines the difference in breastfeeding rates for military-affiliated women and civilian women while considering racial differences within those groups as well. The findings suggest that breastfeeding is more common among military-affiliated women than civilians.
Key Findings
Breastfeeding is 17% more prevalent among women affiliated with the military than civilian women.
White civilian women breastfeed more than Black civilian women but in the military community there is a similar rate of breastfeeding initiation and duration among White and Black women.
Military-affiliated women, on average, breastfeed for a week longer than their civilian counterparts.
Implications for Program Leaders
Offer education to military-affiliated women to explain the importance of breastfeeding
Target low income, unmarried, and non-college educated mothers to recruit them for workshops and offer them resources because they are the least likely to breastfeed
Promote events that encourage and support women through the breastfeeding process to ensure that the ideal duration is met
Implications for Policy Makers
Encourage awareness campaigns about the benefits for infants and mothers to breastfeed
Recommend the development of processes through which new mothers in the military community can be connected to resources that encourage healthy breastfeeding habits
Continue to support high quality healthcare for women affiliated with the military
Methods
The data were collected through the pregnancy risk assessment monitoring system that monitors maternal behaviors among woman who recently delivered an infant during a 10-year period from 1995 through 2005.
Participants were given surveys on paper or by phone that included questions regarding breastfeeding initiation and duration.
Data were analyzed to see how mothers’ responses compare between civilian and military-affiliated populations.
Participants
The study included 6,631 military-affiliated women and 306,808 civilian women who recently delivered a live-born infant.
The ethnic breakdown of participants included 65% White, 18% Black, 5% Asian-American, 11% Latina, and 1% identified as other.
The breakdown of the mother’s age included 11% under 20 years, 58% 20-29 years, 20% 30-34 years, and 11% 35 years or older.
Military-affiliated women included women Service members and wives or daughters of Service members.
Limitations
Researchers did not distinguish between Active Duty Service members and spouses or daughters of military Service members, so it is unclear whether breastfeeding differs for those two groups.
There was no information to indicate whether or not the mothers were employed, which could help explain the differences in breastfeeding initiation and duration.
There were no measurements used to explain the association between Black women breastfeeding less than White women in breastfeeding duration.
Avenues for Future Research
Explore the role that deployment has on breastfeeding initiation and duration
Examine factors that may contribute to the differences between those who initiate breastfeeding in the civilian and military setting
Investigate the features of military environment that may lead to higher rates of breastfeeding
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
We conduct a comparative analysis of breastfeeding behavior between military and civilian-affiliated mothers. Our focus is on African American mothers among whom breastfeeding rates are lowest. The military context may mitigate conditions associated with low breastfeeding prevalence by (a) providing stable employment and educational opportunities to populations who face an otherwise poor labor market and (b) providing universal healthcare that includes breastfeeding consultation. Using pregnancy risk assessment monitoring system (PRAMS) data for which we received special permission from each state to flag military affiliation, we analyze civilians and military affiliate in breastfeeding initiation using logistic regression and breastfeeding duration using Cox proportional hazard analysis. We find that breastfeeding is more prevalent among all women in the military setting and that the black_white gap in breastfeeding duration common among civilians is significantly reduced among military affiliates. Breastfeeding is a crucial component of maternal and child health and eliminating racial disparities in its prevalence is a public health priority. This study is the first to identify the military as an important institutional context that deserves closer examination to glean potential policy implications for civilian society.
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