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US national breastfeeding monitoring and surveillance: current status and recommendations
Donna J Chapman1, Rafael Pérez-Escamilla
1Connecticut NIH EXPORT Center for Eliminating Health Disparities Among Latinos, Department of Nutritional Sciences at the University of Connecticut, Storrs, CT 06269-4017, USA.
Insights
Federal datasets on breastfeeding behaviors lack consistent definitions and comprehensive data, hindering health disparities research. A coordinated US breastfeeding surveillance system is needed, with standardized definitions and expanded data collection for accurate monitoring.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Breastfeeding behaviors are crucial for infant and maternal health.
- Understanding breastfeeding disparities requires comprehensive, standardized data.
- Current federal datasets have limitations in assessing breastfeeding practices.
Purpose of the Study:
- To evaluate federally funded datasets for breastfeeding variables (initiation, duration, exclusivity).
- To determine if datasets collect determinants relevant to health disparities in breastfeeding.
- To identify needs for a coordinated US breastfeeding monitoring and surveillance system.
Main Methods:
- Systematic review of eleven federally funded US datasets.
- Assessment of breastfeeding variables and determinants within each dataset.
- Analysis of data consistency, definitions, and demographic descriptors.
Main Results:
- Datasets exhibited inconsistent breastfeeding definitions and limited ethnic descriptors.
- Variability in the collection of determinants relevant to health disparities.
- Absence of a coordinated national breastfeeding monitoring and surveillance system.
Conclusions:
- Existing datasets are insufficient for a comprehensive health disparities analysis of breastfeeding.
- Standardizing definitions, expanding descriptors, and collecting additional variables are recommended.
- Development of a coordinated US breastfeeding surveillance system is essential.
Abstract:
Eleven federally funded datasets assessing breastfeeding behaviors in the United States (Early Childhood Longitudinal Survey, Infant Feeding Practices Survey II, National Health and Nutrition Examination Survey, National Immunization Survey, National Survey of Children's Health, National Survey of Early Childhood Health, National Survey of Family Growth, Pediatric Nutrition Surveillance System, Pregnancy Nutrition Surveillance System, Pregnancy Risk Assessment Monitoring Survey, and WIC Participant and Program Characteristics) were reviewed to evaluate breastfeeding variables (initiation, duration and exclusivity) and determine whether relevant breastfeeding determinants were collected to evaluate breastfeeding practices from a health disparities perspective. The datasets used inconsistent breastfeeding definitions, limited ethnic descriptors, and varied regarding availability of relevant determinants. Multiple datasets collect breastfeeding data, but a coordinated US breastfeeding monitoring and surveillance system does not exist. Suggestions to improve this system include: standardizing breastfeeding definitions, expanding ethnic/racial descriptors, collecting additional relevant variables, and reducing recall periods.
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