Factors Influencing Exclusive Breastfeeding Up to 6 Months Among Underserved Immigrant Women in New York City

Abstract

Background:

Exclusive breastfeeding for an infant’s first 6 months is recommended for maternal and infant health benefits. Despite rising breastfeeding rates in the United States, the 6-month exclusive breastfeeding rate remains low, particularly among underserved women.

Research Aim:

This study aimed to identify factors influencing exclusive breastfeeding rates during the first 6 months postpartum in a public community hospital serving underserved immigrant populations in New York City.

Method:

This retrospective cohort study analyzed electronic medical records of 1,510 mother–infant dyads who gave birth in 2021. Data were examined over 6 months postpartum to assess breastfeeding initiation, continuation, and associated factors. Descriptive statistics and multivariate logistic regression analyses were conducted.

Results:

The sample was predominantly composed of low-income women (80.3%), Medicaid recipients (94.4%), non-English speakers (63.7%), and Hispanic/Latino individuals (62.5%). Exclusive breastfeeding rates were 18.5% at discharge, 37.2% at 1 month, and 24.6% at 6 months. Maternal, newborn, and hospital-related factors were identified as key determinants. Among maternal factors, age, ethnicity, marital status, mode of delivery, and prior breastfeeding experience predicted adherence. Higher birth weight and elevated bilirubin levels were positively associated with exclusive breastfeeding, while neonatal intensive care unit admission was negatively associated. Postpartum lactation consultation was also a significant hospital-level factor.

Conclusion:

Exclusive breastfeeding rates in this underserved, immigrant population fell below national averages and declined over time. Key maternal, newborn, and hospital-related factors shaped breastfeeding outcomes, revealing critical gaps in lactation support and access to care. Targeted, culturally responsive interventions are essential to improve breastfeeding equity.

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Keywords

breastfeeding exclusive breastfeeding health disparity immigrant women retrospective chart review underserved populations

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