The Impact of Social Factors on the Benefits of Breastfeeding

Although breastfeeding can protect against a variety of childhood illnesses, rates of breastfeeding are low across the USA and are lowest among ethnic minorities. Here, we aimed to explore the relationships between race, socioeconomic status (SES), and the impacts of breastfeeding on common childhood illnesses.

Subjects were recruited from a university-affiliated health system in Southwest Michigan. Data were recorded regarding feeding methods, demographics, and sick visits correlating with five childhood disease states. Insurance status was used as a proxy indicator of SES.

In the overall population, more breastfeeding was associated with a reduced incidence of respiratory illnesses (IRR 0.9991, p = 0.0003) and increased incidence of eczema (IRR 1.0009, p = 0.0297). In white patients, breastfeeding was associated with fewer total diseases (p = 0.004) and respiratory infections (p = 0.0045), while in Black and Hispanic patients, breastfeeding was associated with increased eczema (p = 0.0053 and p < 0.0001, respectively). High-SES white patients had significantly reduced total illnesses (p < 0.0001), ear infections (p = 0.0003), eczema (p < 0.0001), and gastrointestinal illnesses (p = 0.0025). High-SES Black and Hispanic patients had no significant associations with breastfeeding days.

Breastfeeding appeared protective against total illnesses in high-SES, white populations. Infants of color, regardless of SES, experienced no significant protection. We suggest that the benefits of breastfeeding may not compensate for the detrimental health effects of social inequities. Future breastfeeding research should consider the interactions between social factors and the known health benefits of breastfeeding.