The influence of acculturation on breast-feeding initiation and duration in low-income women in the US

While the 'immigrant health paradox' posits better health behaviours and outcomes for immigrants upon arrival to the US, research suggests that this advantage may deteriorate over time. This study analysed the relationship of acculturation and breast-feeding initiation and duration among a sample of predominantly Latina, low-income women in the US. The four measures of acculturation included: mother's nativity (foreign born vs US born), mother's parents' nativity (foreign born vs US born), years of US residence (<8 years vs >= 8 years) and a dichotomous measure of language acculturation adapted from three items on Mann's acculturation scale (preferred language spoken at home, reading language and writing language) as exclusive use of native language versus non-exclusive use (mixed or English only) (Marin et al., 1987; Marin & Gamba, 1996). Final multivariable models showed that mothers who exclusively used their native language were more likely to initiate breast-feeding as well as breast-feed for longer duration compared with mothers with non-exclusive use, whereas years of US residence and mother's nativity were not significantly associated with breast-feeding initiation or duration. Mother's parents' nativity also emerged as a significant predictor of breast-feeding duration, both within filial models for immigrants and across study participants. Programmes providing nutrition education to low-income women may wish to consider the role of language as an important determinant of breast-feeding. The role of mother's parents' nativity on breast-feeding practices deserves exploration in future studies, as the cultural practices taught by family members born outside the US may exert strong pressure within immigrant families now living in the US.