The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.
-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia
Medical researchers have invested considerable effort in identifying and quantifying the numerous nutritional, immunological, and developmental benefits of breastfeeding. Their success explains why the American Pediatric Association (APA) now recommends that mothers breastfeed their infant children for a year, relying exclusively on breastfeeding for their babies’ first six months of life. Unfortunately, the success of medical researchers in documenting the many benefits of breastfeeding contrasts with the frustrating failure of practicing pediatricians in actually persuading American mothers to follow the APA’s breastfeeding recommendations. Public-health scholars report that among infants born in the United States in 2011 in the United States, less than one-fifth (19%) were exclusively breastfed for six months and only about two-fifths (41%) were exclusively breastfed for even three months.
The reasons that American pediatricians often fail in their efforts to promote breastfeeding come into sharper focus in a study recently completed by researchers at the University of North Carolina at Charlotte. For at a time when feminist activists have made maternal marriage optional but maternal employment nearly obligatory, the findings of this new study show that it is married mothers with no plans for out-of-home employment who are most likely to follow the APA’s breastfeeding guidelines.
The authors of the new study focus their analysis on survey data collected from 1,799 women who gave birth to a child between 2005 and 2007 and who indicated that they intended to exclusively breastfeed that child. The researchers then painstakingly identify the characteristics and circumstances differentiating those mothers who actually follow through on their breastfeeding intentions from those who do not. Both the researchers’ statistical findings and their interpretive comments about their findings deserve attention. But the statistical findings ultimately prove more reliable than the interpretive comments.
Marital status looms large in the statistical findings. When processing their data in a simple bivariate statistical model, the researchers calculate that, compared to unmarried peers, married mothers were more than three times as likely to follow the APA recommendation of six months of exclusive breastfeeding (Odds Ratio of 3.07). The statistical linkage between wedlock and APA compliance remains almost identical when the researchers reprocess their data in a more complex, multivariable statistical model that adjusts for maternal education, household income, number of previous children and other background characteristics (Odds Ratio of 2.96).
Out-of-home work intentions likewise show up strongly linked to APA compliance. Using their simple bivariate statistical model, the researchers calculate that compared to peers who return to paid employment six weeks or sooner after the birth of their child, those mothers who indicate that they have “no plan to work” are almost five times as likely to exclusively breastfeed for six months (Odds Ratio of 4.90). Even when using their more complex, multi-variable statistical model, the researchers identify mothers with no employment plans as more than four times as likely to follow the APA breastfeeding recommendation as are peers who return to work within six weeks of their child’s birth (Odds Ratio of 4.26).
Curiously, the authors of the new study do not focus in their conclusions on what their data say about maternal marital status and maternal employment. Yes, in summarizing their conclusions, the researchers do briefly acknowledge that “baby’s father’s support of breastfeeding” and mother’s “having no plans to return to work” were (along with maternal education and not smoking during the prenatal period) “significantly associated with exclusively breastfeeding to at least 3 months.” But readers can only consider it strange that the researchers do not underscore wedlock in their summary comment on their statistical findings. After all, the statistical linkage between exclusive breastfeeding and marital status is stronger than the linkage between such breastfeeding and baby’s father’s support of the practice, decidedly so for the APA standard of six months of such breastfeeding (Odds Ratios of 2.96 vs. 1.77 for six months in the multivariable statistical model).
And rather than linger on the politically sensitive finding that APA compliance is most likely among mothers with no plans to return to employment, the authors of the new study focus on the elevation of APA compliance among mothers who “strongly valued exclusive breastfeeding.” The researchers correctly note that compared to peers who did not so value exclusive breastfeeding, “mothers who strongly valued exclusive breastfeeding had over 2 times the odds of exclusively breastfeeding for at least 3 months (Adjusted Odds Ratio [AOR] 2.29) and 6 months (AOR 2.49).” And on the basis of this finding, the researchers argue that the time is ripe for “investing in programs that focus on maternal education of exclusive breastfeeding benefits.” Such efforts, they explain, should be “comprehensive and offered in diverse settings including high schools, work sites and community centers.”
Perhaps educational efforts designed to realign maternal values may accomplish some good. But the data unambiguously identify both maternal marital status and maternal employment plans as larger concerns for anyone serious about improving maternal compliance with the APA’s breastfeeding recommendation. The public-health policies that would most benefit infants in this regard are unmistakably those that would put more new mothers in enduring marriages and those that would put such mothers indefinitely in their own home rather than in an office or factory. Until they are willing to defy political correctness by advocating such policies, public-health officials are likely to continue coming up short in their educational attempts to promote breastfeeding.
(Uche H. Nnebe-Agumadu et al., “Associations between Perceived Value of Exclusive Breastfeeding among Pregnant Women in the United States and Exclusive Breastfeeding to Three and Six Months Postpartum: A Prospective Study,” International Breastfeeding Journal 11 : 8. Web. Emphasis added.)