Breastfeeding
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Headline

In 2004, non-Hispanic black mothers were less likely than non-Hispanic white, Hispanic, and Asian mothers to breastfeed their infants at six months (21 percent compared with 38 percent for non-Hispanic white mothers and 40 percent for Hispanic and Asian mothers). (See Table 1)

Importance

Breastfeeding is important because of the nutritional, health, immunological, developmental, and psychological benefits that breast milk provides for infants and children. ^1,2 The American Academy of Pediatrics recommends breastfeeding as the best type of nutrition for infants.³

Research shows that infants who are breastfed are less likely to suffer from diarrhea, ear infections, lower respiratory infections, urinary tract infections, and bacterial meningitis. Breast milk may also help protect against allergies, Sudden Infant Death Syndrome, and digestive disorders. ^4,5 Breastfed infants are less likely to need visits to doctor's offices and hospitals and are less likely to need pharmaceuticals. Studies have also explored the lasting benefits of breastfeeding, suggesting that breastfeeding may improve long term immunological response.⁶ In addition, breastfeeding may have health benefits for the mother, with one study finding that mothers who breastfeed for a longer period of time were less likely to develop type 2 diabetes, even when controlling for other risk factors. ⁷

In regard to cognitive and developmental benefits, research has shown a positive association between longer breastfeeding and improved school performance in children and adolescents and higher IQ in adults. ^8,9

Lastly, the act of breastfeeding has psychological benefits for both the mother and infant. Breastfeeding is a time of physical contact and closeness, nurturing the bond between mother and child.¹⁰

Trends

In 2004, 70 percent of mothers reported ever breastfeeding their infants, 36 percent reported still breastfeeding at six months, and 18 percent reported breastfeeding at 12 months. (See Table 1 ) Between 2003 and 2004, there was little change in breastfeeding rates.

Data from another source also indicate that rates of breastfeeding have increased substantially since 1990. For example, the percentage of mothers breastfeeding at six months rose from 18 percent in 1990 to 33 percent in 2002. (See Figure 1)

Note: Data for trends from 1970-2002 were taken from the Ross Mother's Survey, while data for 2003 and 2004 came from the National Immunization Survey.

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Differences by Race and Ethnicity

In 2004, non-Hispanic black mothers were less likely than non-Hispanic white, Hispanic, and Asian mothers to breastfeed their infants at six months (21 percent compared with 38 percent for non-Hispanic white mothers and 40 percent for Hispanic and Asian mothers). (See Figure 2)

Differences by Poverty Status

Mothers living below the poverty line were less likely to breastfeed in 2004. At six months, 30 percent of mothers living below the poverty line breastfed their six-month-old infant, and of those living between 100 percent and 185 percent of the poverty line, 33 percent breastfed. In comparison, mothers living at 185 percent to 350 percent of the poverty line and those above 350 percent of the poverty line breastfed at rates of 38 percent and 46 percent, respectively. (See Figure 3)

Differences by WIC Receipt

Similarly, mothers who were receiving the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were significantly less likely than both mothers eligible but not receiving WIC and mothers not eligible and not receiving WIC to breastfeed at six months (29 percent versus 46 percent and 47 percent, respectively). (See Table 1) This may reflect the lower education or income level of WIC recipients.

Differences by Maternal Education

Mothers who are college graduates were more likely to breastfeed their infants than mothers with lower levels of educational attainment. In 2004, 52 percent of mothers with a college education breastfed their infant at six months compared with 35 percent with some college education, 28 percent with a high school degree, and 30 percent with less than a high school degree. (See Table 1)

Differences by Maternal Age

Young mothers are substantially less likely than older mothers to breastfeed their infants. In 2004, 14 percent of mothers ages 19 or younger breastfed their infant at six months, compared with 30 percent of mothers ages 20 to 29 and 44 percent of mothers 30 and older. (See Figure 4)

Related Indicators

Late or No Prenatal Care

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State and Local Estimates

2004 state and select county breastfeeding estimates are available from the National Immunization Survey at National Survey for Children's Health at http://www.cdc.gov/breastfeeding/data/NIS_data/data_2004.htm (Select table 2)

2003 state estimates on breastfeeding for children ages 0-5 are available through the National Survey for Children's Health at http://nschdata.org/dataquery/surveyareas.aspx (Select Health Status under State Profile)

International Estimates

International estimates of infant feeding can be obtained from UNICEF at http://www.childinfo.org/eddb/brfeed/test/database.htm

National Goals

Through the Healthy People 2010 initiative, the federal program is promoting breastfeeding as one of many ways to improve American's health. The program included objectives to increase the number of mothers who breastfeed at early postpartum, six months, and 12 months. For 2010, the target rate for mothers who breastfeed is 75 percent at early postpartum and 50 percent at six months.

More information is available at http://www.healthypeople.gov/Document/HTML/Volume2/16MICH.htm#_Toc494699668

In addition, the U.S. Department of Health and Human Services has published "Blueprint for Action of Breastfeeding", which presents a national plan to promote breastfeeding based on education, research, awareness, and support. The document is available online at http://www.cdc.gov/breastfeeding/pdf/bluprntbk2.pdf

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What Works: Programs that May Influence this Indicator

None available at this time.

Research References

¹Bright Futures, "Nutrition Issues and Concerns," Bright Futures in Practice: Nutrition (2nd ed.). Available at http://www.brightfutures.org/nutrition/pdf/concerns.pdf
²Work Group on Breastfeeding, American Academy of Pediatrics. "Breastfeeding and the Use of Human Milk," Pediatrics 100 (December 1997): 1035-1039.
³Work Group on Breastfeeding, 1997.
⁴Ibid.
⁵Ibid.
⁶Bright Futures
⁷Stuebe, Alison M., Rich-Edwards, Janet W., Willet, Walter C., Manson, JoAnn E., and Michels, Karin B. (2005). "Duration of Lactation and Incidence of Type 2 Diabetes." Journal of the American Medical Association, 294 (20): 2601-10.
⁸E.L. Mortensen, K.F. Michaelsen, S.A. Sanders, and J.M. Reinisch, "The Association Between Duration of Breastfeeding and Adult Intelligence," Journal of the American Medical Association 297 (2002): 2365-2371.
⁸Bright Futures
⁹American Academy of Pediatrics. (2000). "A Woman's Guide to Breastfeeding." Available at http://parentingthoughts.org/guidtobrstfdng.htm.

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Definition

In the context of this indicator, breastfeeding was defined as the child being fed breast milk directly from the mother or milk that was pumped from the mother's breast.

Data Source

Data for 2004: U.S. Department of Health and Human Services Centers for Disease Control and Prevention. "Data and Statistics: Breastfeeding Practices - Results from the 2004 National Immunization Survey." Available online at http://www.cdc.gov/breastfeeding/data/NIS_data/data_2004.htm.

Data for 2003: U.S. Department of Health and Human Services Centers for Disease Control and Prevention. Breastfeeding Practices: Results from the 2003 National Immunization Survey. Available online at http://www.cdc.gov/breastfeeding/NIS_data/index.htm

Data for 1975-2002: Ross Products Division, Abbott Laboratories. (2002). 2002 Breastfeeding Trends Report. Cleveland, OH. Available online at http://www.ross.com/aboutRoss/mediaResources.asp

Raw Data Source

National Immunization Survey, conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. http://www.cdc.gov/nis/

The Ross Mothers Survey is a nationally representative cross-sectional survey. The multiple-choice survey is mailed annually to new mothers and has a return rate of about 31 percent.

Approximate Date of Next Update

Summer 2006

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