Educational and Racial Disparities in Breastfeeding: Associations with Work Status, Social Support, and Stress

Area of Science:

• Maternal and Child Health
• Health Disparities Research
• Socioeconomic Determinants of Health

Background:

• Socioeconomic status (SES) is a known factor influencing health outcomes, including infant feeding practices.
• Understanding the intersection of race and SES is crucial for addressing breastfeeding disparities.
• Previous research indicates variations in breastfeeding rates across different demographic groups.

Purpose of the Study:

• To examine breastfeeding patterns at discharge based on race and educational attainment.
• To investigate whether social support, stress, and employment status mediate the relationship between race/SES and breastfeeding.
• To identify disparities in breastfeeding initiation by race and socioeconomic status.

Main Methods:

• Secondary analysis of the Measurement of Maternal Stress Study (n=636).
• Survey data collected on perceived stress, social support, and work hours during pregnancy.
• Race categorized as white or People of Color (POC); SES categorized by educational attainment (low, moderate, high). Infant feeding data abstracted from medical records. Logistic regressions used to test associations.

Main Results:

• Low-SES POC had significantly lower odds of breastfeeding at discharge compared to high-SES white participants (aOR: 0.10, 95% CI: 0.04, 0.23).
• Higher SES was associated with increased odds of breastfeeding across all racial/ethnic groups.
• Working more hours, increased social support, and perceived stress were not significantly associated with breastfeeding at discharge.

Conclusions:

• Breastfeeding initiation is influenced by the combined effects of educational attainment and race/ethnicity.
• Social support, employment status, and perceived stress did not explain observed differences in breastfeeding outcomes.
• Strategies to achieve breastfeeding equity must consider the intersectional impact of race and SES.