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Challenges and Opportunities of Using a National Database to Evaluate Racial/Ethnic Disparities and Breastfeeding

Sera Yoo1, Menaka Dhingra2, John Gaughan3

  • 1Cooper Medical School of Rowan University, Camden, New Jersey, USA.

Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine
|October 18, 2022
PubMed

Insights

Sudden unexpected infant death (SUID) rates are higher in Black and Native American infants. Breastfeeding is linked to lower SUID risk, but race confounded this relationship in analyses.

Area of Science:

  • Public Health
  • Epidemiology
  • Infant Mortality

Background:

  • Sudden unexpected infant death (SUID) rates disproportionately affect American Indian/Alaska Native (AI/AN) and non-Hispanic Black (NHB) infants.
  • Racial disparities in breastfeeding practices are also observed, with breastfeeding being a known protective factor against SUID.

Purpose of the Study:

  • To investigate the association between racial/ethnic disparities in SUID and breastfeeding rates beyond the immediate newborn period.
  • To analyze national data to understand the interplay between race, breastfeeding, and SUID risk.

Main Methods:

  • Utilized data from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) and National Immunization Surveys (NISs) from 2009-2017.
  • Analyzed breastfeeding rates (ever, at 6 months, exclusive) and SUID data aggregated by race/ethnicity.
  • Employed weighted multivariable linear regression to assess mortality rates.

Main Results:

  • NHB and AI/AN infants exhibited the highest SUID rates and lowest breastfeeding rates.
  • Race/ethnicity confounded the relationship between breastfeeding and SUID when both were included in analyses.
  • Excluding race from the analysis revealed that ever breastfeeding and breastfeeding at 6 months were associated with significantly reduced SUID rates.

Conclusions:

  • Race/ethnicity acts as a confounding factor in the relationship between breastfeeding and SUID.
  • Limitations include the unavailability of individual-level SUID data linked to breastfeeding status.
  • Enhanced national data collection is needed to fully elucidate the role of breastfeeding in mitigating SUID racial disparities.

Keywords:
breastfeedinginfant mortalitysocioeconomic factorssudden unexpected infant death

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