Couples’ Immigration, and Ethnicity as Determinants of Breastfeeding

Objectives: We investigated how couples’ immigration status and ethnicity determined the decision to initiate breastfeeding and to breastfeed at six months. Methods: From data collected on 4,207 mothers and 3,013 fathers participating in a longitudinal birth cohort study, we used linear regression and covariate-adjusted proportions to estimate the determinants of breastfeeding behaviors. The sample was divided by immigration status (either foreign-born or born in the United States) and further sub-divided by ethnicity (Mexican Hispanic, non-Mexican Hispanic, and non-Hispanic). Results: Mothers born in the U.S. are 85% less likely to breastfeed than are foreign- born mothers and 66% less likely to be breastfeeding at six months. Each additional year of U.S. residency decreases breastfeeding rates by 4%. These differences by immigration status were seen for Mexicans, other Hispanics, and non- Hispanics. Conclusion: The Hispanic paradox may extend to other non-Hispanic immigrants for breastfeeding behaviors, but may not be true for Hispanic mothers born in the United States. Low rates of breastfeeding for American Hispanic mothers indicate that they should not be overlooked by breastfeeding promotion programs.

Duke Scholars

Author Christina M. Gibson-Davis Sanford School of Public Policy