Citation
Kogan, Michael D.; Singh, Gopal K.; Dee, Deborah L.; Belanoff, Candice; & Grummer-Strawn, Laurence M. (2008). Multivariate Analysis of State Variation in Breastfeeding Rates in the United States. American Journal of Public Health, 98(10), 1872-1880. PMCID: PMC2636475Abstract
Objectives: We sought to determine the impact of sociodemographic and behavioral factors and state legislation on breastfeeding initiation (child ever fed breastmilk) and duration.Methods: We used data from a nationally representative study of children aged 6 to 71 months (N=33 121); we calculated unadjusted and adjusted state estimates for breastfeeding initiation and duration. We used logistic regression models to examine factors associated with never breastfeeding or breastfeeding less than 6 months. We conducted a multilevel analysis of state legislation's role.
Results: There were wide state variations in breastfeeding initiation and duration. The western and northwestern states had the highest rates. Covariate adjustment accounted for 25% to 30% of the disparity. Multivariate analysis showed that the adjusted odds of not being breastfed were 2.5- to 5.15-times greater in southern states compared with Oregon (reference). Children in states without breastfeeding legislation had higher odds of not being breastfed.
Conclusions: Sociodemographic and maternal factors do not account for most breastfeeding rate variation. The association with breastfeeding legislation should be explored and may reflect cultural norms.
URL
http://dx.doi.org/10.2105/AJPH.2007.127118Reference Type
Journal ArticleYear Published
2008Journal Title
American Journal of Public HealthAuthor(s)
Kogan, Michael D.Singh, Gopal K.
Dee, Deborah L.
Belanoff, Candice
Grummer-Strawn, Laurence M.