(P07-11-26) Understanding Early Decline in Exclusive Breastfeeding Among Latine Families in a Rural United States-Mexico Border County

Objectives: Exclusive breastfeeding is recommended for 6 months, yet racial and ethnic disparities persist in the U.S. This study characterized infant feeding practices and examined facilitators and barriers to exclusive human milk (EHM) feeding in the first 2 months among Latine families living in a rural U.S.-Mexico border county.

Methods: This study was conducted in a rural Arizona border county from Nov 2022 to Dec 2023. EHM feeding was defined as feeding only human milk with no other solids or liquids. The quantitative component was a secondary analysis of infant feeding practices identified via chart review of all infants ≤2 months who attended at least 1 well-baby visit at a Federally Qualified Health Center between Dec 2022 and Jun 2023 (n=214). The qualitative component purposively sampled Latina women within 2 months postpartum (n=28), healthcare providers (n=5), and nutrition service providers (n=7) for in-depth interviews. Interviews focused on prenatal breastfeeding intentions and practices in the first 2 months postpartum. Themes were identified through inductive and deductive coding in Dedoose.

Results: Among 214 infants, only 20.1% received EHM in the first week after discharge, declining to 7.9% at 1 month and 6.1% at 2 months. Of the 28 postpartum women interviewed, 71% primarily spoke Spanish and 25% grew up in Mexico. Most (n=18) fed their infants formula during postpartum hospitalization. Facilitators of EHM feeding included prenatal intentions to provide EHM and family help with bottle-feeding expressed milk upon return to work. Barriers included in-hospital formula provision, perceived milk insufficiency and return to work within 1-2 months. Healthcare and nutrition providers corroborated these barriers and noted limited support for Spanish-speaking families at birthing hospitals.

Conclusions: EHM feeding prevalence was low in the first week and declined further by 2 months, suggesting immediate and sustained barriers. In-hospital formula use may have undermined early EHM feeding. Interventions should address in-hospital formula use and human milk insufficiency concerns by strengthening hospital lactation support and connecting families to local lactation services before discharge. To address return to work as a key barrier, stronger workplace protections for milk expression are needed.

Funding Sources: Vitamin Angel Alliance