Breastfeeding

Duration and
Support in the United
States
Rachel West
University of Texas at San
Antonio

Background
vidence from the CDCs 2014 Breastfeeding Report
Card confirms that breastfeeding rates continue to
rise in the United States.
reastfeeding is beneficial to new mothers, babies,
families, and even communities as a whole.
reastfeeding duration is often dependent on a
number of factors. Age, socioeconomic status,
education level, ethnicity, health status, and
access to lactation support often determine the
duration of time that a mother breastfeeds.
Using research obtained from the CDCs
Breastfeeding Report Cards from 2009-2014, I will
determine breastfeeding rates of infants at 6
months and 12 months over the past five years.
dditionally, I will identify 3 major types of
breastfeeding support that influence breastfeeding
duration and patterns.
he American Academy of Pediatrics released a
policy statement about breastfeeding in the
Official Journal of the American Academy of
Pediatrics entitled Breastfeeding and the Use of
Human Milk. In this statement, the AAP
recommends exclusive breastfeeding for about
the first six months of a baby's life, followed by
breastfeeding in combination with the introduction
of complementary foods until at least 12 months
of age, and continuation of breastfeeding for as
long as mutually desired by mother and baby

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Background
reastfeeding is beneficial to new mothers, babies,
families, and even communities as a whole.
reastfeeding decreases the likelihood that a baby
will develop ear infections, diarrhea, respiratory
problems, allergies, child leukemia,
neurodevelopmental issues, obesity, diabetes,
and a number of other infectious diseases.
reastfeeding is beneficial to the mother because
it helps her return to her pre-pregnancy weight
faster, have increased child spacing, experience
less post-partum depression and have a reduced
risk of breast and ovarian cancer. New mothers
also experience less postpartum bleeding,
because the hormones that promote
breastfeeding also help the uterus to contract.
or the family, breastfeeding facilitates bonding
experiences. For the community, breastfeeding
helps promote healthy and happy citizens.
Breastfeeding is undoubtedly cost effective as
well. It also helps the environment by saving
water, conserving energy for manufacturing, and
by not polluting the environment with waste
(garbage) or air pollution from manufacturing.
Moreover, there is never a concern about the risk
of contamination from bacteria or other
substances because it is always fresh, and at the
perfect temperature.

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The Research Questions

hat are the breastfeeding
rates of infants at 6
months and 12 months
over the past five years?

Additionally, how do the

three major types of
breastfeeding support
influence breastfeeding
duration and patterns?

Overview of the Research

he Hypothesis: If adequate breastfeeding support exists for new
mothers, then breastfeeding durations and rates will increase.
esearch Design: Using the CDCs Breastfeeding Report Cards
from 2009 to 2014, I obtained data on the number of
households that ever breastfed, that breastfed at six months,
that breastfed exclusively at six months, and that breastfed at a
year. Additionally, I obtained data on the number of state health
department full time employees dedicated to breastfeeding, the
average mPINC (Maternity Practices in Infant Nutrition and Care)
score, and the percent of live births occurring at facilities
designated as baby friendly. Finally, I observed trends in the
data and drew conclusions on the relationship between
breastfeeding rates and durations and breastfeeding support.

Research Design and Methods

The CDC generated their
Breastfeeding Report Cards using
data obtained from the National
Immunization Survey (NIS). This
survey uses random-digit dialing
to survey households with
children aged 19-35 months.
Since January 2003, the National
Immunization Survey asks all
respondents breastfeeding
questions. The Council of
American Survey and Research
Organizations response rates for
the landline samples of the
National Immunization survey
are consistently over 60%.

The Results
Breastfeeding Duration and Rates
In
2009, 73.9% of all households sampled reported ever breastfeeding their infant. 43.4% of
households sampled reported breastfeeding at 6 months, while only 13.6% reported exclusive
breastfeeding at 6 months. 22.7% of households sampled reported breastfeeding at 12 months.
In
2010, 75% of all households sampled reported ever breastfeeding their infant. 43% of households
sampled reported breastfeeding at 6 months, while only 13.3% reported exclusive breastfeeding at
6 months. 22.4% of households sampled reported breastfeeding at 12 months.
In
2011, 74.6% of all households sampled reported ever breastfeeding their infant. 44.3% of
households sampled reported breastfeeding at 6 months, while only 14.8% reported exclusive
breastfeeding at 6 months. 23.8% of households sampled reported breastfeeding at 12 months.
In
2012, 76.9% of all households sampled reported ever breastfeeding their infant. 47.2% of
households sampled reported breastfeeding at 6 months, while only 16.3% reported exclusive
breastfeeding at 6 months. 25.5% of households sampled reported breastfeeding at 12 months.
In
2013, 76.5% of all households sampled reported ever breastfeeding their infant. 49% of
households sampled reported breastfeeding at 6 months, while only 16.4% reported exclusive
breastfeeding at 6 months. 27% of households sampled reported breastfeeding at 12 months.
Finall
y, in 2014, 79.2% of all households sampled reported ever breastfeeding their infant. 49.4% of
households sampled reported breastfeeding at 6 months, while 18.8% reported exclusive
breastfeeding at 6 months. 26.7% of households sampled reported breastfeeding at 12 months.

The Results
Breastfeeding Duration and Rates

The Results
Breastfeeding Support
T
he number of state health department full time employees
dedicated to breastfeeding was 79.79 in 2009, 96.79 in
2010, 125.06 in 2011, 135 in 2012, and unfortunately
unknown in 2013 and 2014.
T
he average mPINC score was 63 in 2009, 65 in 2010, 65 in
2011, 70 in 2012, 75 in 2013, and 75 in 2014.
T
he percent of live births occurring at facilities designated as
Baby Friendly was 2.87% in 2009, 3.78% in 2010, 4.53% in
2011, 6.22% in 2012, 7.15% in 2013, and 7.79 in 2014.

The Results
Breastfeeding Support

Research Questions, Answers, and

Trends
earch Questions: What are the breastfeeding rates of infants at 6 months and 12
months over the past five years? Additionally, how do the three major types of
breastfeeding support influence breastfeeding duration and patterns?

Res

Res
earch Answer: Overall, as breastfeeding support increased from 2009 to 2014, the
number of households that ever breastfed, that breastfed at 6 months, that
exclusively breastfed at 6 months, and that breastfed at 12 months increased as well.
Dat
a trends: Despite the AAPs recommendations of exclusive breastfeeding for the first 6
months, the percentage of mothers exclusively breastfeeding at 6 months is quite low.
Although, from 2009-2014, the percentage of exclusive breastfeeding at 6 months
grew from 13.3% in 2010, to 18.8% in 2014. Another trend evident in the data is that
overall; the percentage of households sampled that reported ever breastfeeding their
infant has increased from 73.9% in 2009 to 79.2% in 2014. Additionally, the
percentage of households that reported breastfeeding at 12 months has increased
from 22.4% in 2010 to 26.7% in 2014. Finally, the percentage of households that
reported any breastfeeding at 6 months is on the rise as well, from 43% in 2010 to
49% in 2014.
The
trends found in breastfeeding support from 2009-2014 are positive. The number of
state health department full time employees dedicated to breastfeeding increased
from 79.79 in 2009 to 135 in 2012. Although the data is unavailable for 2013 and
2014, I believe it is safe to assume that the number of employees grew. The average
mPINC score increased from 63 in 2009 to 75 in 2014 and the percent of live births

Conclusion

Research Questions: What are the breastfeeding rates of infants at 6

months and 12 months over the past five years? Additionally, how do the
three major types of breastfeeding support influence breastfeeding
duration and patterns?

Hypothesis: If adequate breastfeeding support exists for new mothers,

then breastfeeding durations and rates will increase.
Research Answer: Overall, as breastfeeding support increased from 2009
to 2014, the number of households that ever breastfed, that breastfed at
6 months, that exclusively breastfed at 6 months, and that breastfed at
12 months increased as well.
The results of the research are significant because they demonstrate the
importance of breastfeeding support for new mothers. The results suggest
that with proper support, mothers can and will breastfeed at higher rates
for longer durations. This research can help reflect the need for increased
breastfeeding support. The government, medical institutions, and birthing
centers could use this research in order to determine the amount of
funding or staff they should allocate towards breastfeeding support

New Questions & Refining, Repeating,

and Follow-Up Research
ew Questions: What other kinds of breastfeeding support determine
breastfeeding duration and rates? Are other kinds of breastfeeding
support increasing as well? What are new advances in breastfeeding
support?
efining and Repeating Research: I would have liked for there to have
been data on State Health Department full time employees dedicated to
breastfeeding for 2013 and 2014. I would like to refine the research to
either include this data from 2013 and 2014 or provide information on
another type of breastfeeding support. If I repeated this research, I
would include other kinds of breastfeeding support.
lans for Follow Up Research: I am active in birth work, including
postpartum support, therefore I am constantly interacting with mothers
who are breastfeeding or attempting to breastfeed. If I decided to do
follow up research, I could inquire about what kinds of support they find
the most helpful and determine what influences their choices for
continuing to breastfeed.