(PTFS09-04-26) Breastfeeding Practices Among Foreign-Born Non-Hispanic Mothers of Children in the United States: A Snapshot From the National Survey of Children’s Health

Objectives: Breastfeeding (BF) has well-established health benefits for mothers and children, but major disparities persist by race, ethnicity, nativity, socioeconomic status and region. This study examines breastfeeding practices among an understudied population-foreign-born, non-Hispanic (FBNH) mothers- compared to foreign-born Hispanic (FBH) and U.S.-born mothers and explores socioeconomic factors influencing FBNH mothers’ ability to meet recommended infant feeding practices.

Methods: We analyzed cross-sectional data on U.S. children ages 0–5 y from the 2022–2023 National Survey of Children’s Health to assess the following breastfeeding practices- BF initiation, exclusive breastfeeding (EBF) for 6 months, BF ≥12 months, and optimal BF (all three practices)- among FBNH, FBH and U.S. born mothers. Chi-square tests were used to compare proportions, and multivariable binomial regression models estimated prevalence ratios for breastfeeding outcomes by nativity & ethnicity, maternal employment status, community and social support, and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation.

Results: Among our sample of FBNH mothers (n=3817), 87.7% initiated BF, 28.2% practiced EBF for 6 months, 46.2% breastfed ≥12 months, and less than a quarter (21.8%) met all three practices. U.S. born mothers had significantly lower prevalence of BF initiation (83.1% vs. 87.7%, p=0.04), while FBH had significantly higher prevalence of EBF at 6 months (31% vs. 28.2%, p=0.02) and overall optimal breastfeeding (24.7% vs. 21.8% p=0.04) in the adjusted models, when compared to FBNH mothers. Maternal employment status, community and social support, and WIC participation were not associated with breastfeeding outcomes among FBNH mothers.

Conclusions: Despite high rates of breastfeeding initiation, only one in five FBNH women achieved all recommended breastfeeding practices, and over 70% did not meet exclusive breastfeeding recommendations. Known predictors of breastfeeding- maternal employment status, community/social support and WIC participation- were not associated with optimal BF practices, highlighting the need for further research to identify modifiable drivers of BF practices among this population.

Funding Sources: No external funding