Women who give birth at California hospitals serving mostly minority, low-income patients less likely than others to breastfeed

Sep 4 2008

Women who give birth at California hospitals serving mostly non-white, low-income women and children are less likely to breastfeed than women who give birth at other hospitals around the state, according to a report released from the University of California-Davis Human Lactation Center and the California WIC Association, the Riverside Press-Enterprise reports (Dean, Riverside Press-Enterprise, 9/2).

Research has shown that breastfeeding can reduce the likelihood of childhood obesity and ear infections and boosts children's immune systems (Reiter, Merced Sun-Star, 9/3). Hospitals with the highest rates of women who exclusively breastfed had trained staff, made lactation specialists available and supported exclusive breastfeeding, unless there was a medical reason not to, the Modesto Bee reports.

The report found, for example, that about 59% of white women in Stanislaus County who gave birth at hospitals reported breastfeeding their newborns exclusively, while 33% of Hispanic women and 32% of black women said they exclusively breastfed. The report's findings raise concerns that more targeted efforts are needed to address cultural gaps, according to the Bee (Carlson, Modesto Bee, 9/3).

Eighty-seven percent of women statewide began breastfeeding while at the hospital, the report found (Riverside Press-Enterprise, 9/2). However, an average of 42.7% of women continued to exclusively breastfeed their infants after leaving the hospital, according to the report (Halstead, Marin Independent Journal, 9/2). The California Department of Public Health has guidelines to help hospitals promote breastfeeding and emphasizes exclusive breastfeeding in the hospital, which can influence whether the infant will be breastfed at home (Modesto Bee, 9/3). Lisa Keckler, head of a breastfeeding quality improvement task force at Doctors Medical Center of Modesto, said that the hospital's lower breastfeeding rates could be explained by some premature infants having to spend time in intensive care. In addition, some women might have to return to work soon after giving birth and supplement breastfeeding with formula, she added.

The report also found that California hospitals with the World Health Organization's "baby-friendly" designation reported higher rates of women who breastfeed exclusively after leaving the hospital (Modesto Bee, 9/3). The program involves 10 steps to help improve breastfeeding rates and lower infant mortality rates and can include classes, lactation counseling and other services to assist women after giving birth (Riverside Press-Enterprise, 9/2). At the 19 baby-friendly hospitals in California, 71% of white women, 66% of Hispanic women and 62% of black women breastfed (Modesto Bee, 9/3).

Karen Farley, program manager of California WIC Association, said, "Our report shows that virtually all of the hospitals with the lowest exclusive breastfeeding rates reported here serve low-income and minority women -- the very population most affected by poor health outcomes such as diabetes and obesity" (Riverside Press-Enterprise, 9/2). She added, "Breastfeeding should not depend on where you are born."We know that when babies are exclusively breastfed in the hospital, they are more likely to be breastfed exclusively at home. We know these babies have healthier outcomes" (Modesto Bee, 9/3).

The report is available online.