Breastfeeding advice given to African American and white women by physicians and WIC counselors

Public Health Rep. Jul-Aug 2003;118(4):368-76. doi: 10.1093/phr/118.4.368.


Objective: This study determined rates of breastfeeding advice given to African American and white women by medical providers and WIC nutrition counselors, and sought to determine whether racial differences in advice contributed to racial differences in rates of breastfeeding.

Methods: The study used data from the 1988 National Maternal and Infant Health Survey, a cross-sectional survey of a nationally representative sample of mothers with a live birth, infant death, or fetal death in 1988. The authors compared white women (n=3,966) and African American women (n=4,791) with a live birth in 1988 on self-reported rates of medical provider and WIC advice to breastfeed, WIC advice to bottlefeed, and breastfeeding.

Results: Self-reported racial identification did not predict medical provider advice. However, being African American was associated with less likelihood of breastfeeding advice and greater likelihood of bottlefeeding advice from WIC nutrition counselors. In multivariate analyses controlling for differences in advice, being African American was independently associated with lower breastfeeding rates (odds ratio [OR] = 0.41, 95% CI 0.32, 0.52).

Conclusions: African American women were less likely than white women to report having received breastfeeding advice from WIC counselors and more likely to report having received bottlefeeding advice from WIC counselors. However, African American and white women were equally likely to report having received breastfeeding advice from medical providers. Lower rates of breastfeeding advice from medical or nutritional professionals do not account for lower rates of breastfeeding among African American women.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / education*
  • African Americans / psychology
  • Attitude of Health Personnel / ethnology
  • Breast Feeding / ethnology*
  • Breast Feeding / statistics & numerical data
  • Chi-Square Distribution
  • Counseling / standards*
  • Counseling / statistics & numerical data
  • Cross-Sectional Studies
  • European Continental Ancestry Group / education*
  • European Continental Ancestry Group / psychology
  • Female
  • Health Care Surveys
  • Healthy People Programs
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Middle Aged
  • Mothers / education
  • Mothers / psychology
  • Mothers / statistics & numerical data
  • Multivariate Analysis
  • Patient Education as Topic / standards*
  • Patient Education as Topic / statistics & numerical data
  • Pregnancy
  • Prenatal Care / standards*
  • Socioeconomic Factors
  • United States