Maternity Care Practices and Their Role in U.S. Breastfeeding Disparities
Luis Seoane Estruel1,2, Tatiana Andreyeva1,2
1Department of Agricultural and Resource Economics, University of Connecticut, Storrs, Connecticut, USA.
Summary
Improving hospital maternity care significantly boosts breastfeeding initiation rates, especially for Black and Native American mothers. Quality care is key to reducing disparities in breastfeeding.
Area of Science:
- Public Health
- Maternal and Child Health
- Health Services Research
Background:
- Breastfeeding offers significant health advantages to infants and mothers, but U.S. initiation rates are suboptimal.
- Existing disparities in breastfeeding rates are influenced by structural, social, and policy factors.
- Hospital maternity care practices are a critical, yet understudied, determinant of breastfeeding initiation.
Purpose of the Study:
- To examine the influence of U.S. hospital maternity care quality on breastfeeding initiation.
- To assess how these influences vary across different racial/ethnic and geographic population groups.
- To identify potential strategies for reducing breastfeeding disparities through improved maternity care.
Main Methods:
- Analysis of cross-sectional county-level data from 2017-2022.
- Utilized data from the National Vital Statistics System and Maternity Practices in Infant Nutrition and Care (mPINC) surveys.
- Employed a linear probability model to assess the association between maternity care quality scores and breastfeeding initiation.
Main Results:
- Higher county mPINC scores were significantly associated with increased breastfeeding initiation (0.10 pp increase per point, p < 0.001).
- The positive association was notably stronger for non-Hispanic Black mothers (0.25 pp) and non-Hispanic American Indian/Alaska Native mothers (0.14 pp) compared to non-Hispanic White mothers.
- Better maternity care practices showed a greater impact in nonmetro areas (0.17 pp increase) compared to metro areas (0.08 pp increase).
Conclusions:
- Higher quality hospital maternity care is linked to increased breastfeeding initiation.
- Improvements in maternity care practices show a disproportionately positive effect on populations with historically lower breastfeeding rates.
- Enhancing hospital maternity care policies and practices presents a viable strategy to mitigate long-standing breastfeeding disparities.
Keywords:
breastfeedingdisparitieshealth disparitieshospital maternity careinfant nutritionmaternal healthMore Related Videos
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