The Impact of Sex of Child on Breastfeeding in the United States

Background Sex of child has been shown to impact breastfeeding duration in India, Australia, Scandinavia, Latin America, and, within the US, in a sample in Eastern Connecticut and in a separate sample of Indian and Chinese immigrants. Objectives The objective of this study is to examine differences in breastfeeding initiation and duration by sex of child across racial/ethnic groups in the US. Methods We used the Pregnancy Risk Assessment Monitoring System 2009-2010 and logistic regression to examine whether sex of child impacts breastfeeding initiation and duration for at least 8 weeks by women's racial/ethnic group. Results Among the 66,107 women in our sample representing 12 different race/ethnic groups, Hispanic women (n = 9049) had lower odds of breastfeeding initiation (adjusted odds ratio [AOR] = 0.81, 95% CI 0.71-0.93) and breastfeeding duration (AOR = .87, 95% CI 0.80-0.96) if they have sons compared to Hispanic women who have daughters. Sex of child did not impact the odds of breastfeeding initiation or duration among any other race/ethnic group. Conclusion We have shown that, for Hispanics in the US, sex of child may have an impact on breastfeeding, a health behavior that has a variety of positive impacts on infants throughout their lives. Boys, relative to girls, were at a disadvantage in breastfeeding initiation and duration. Future work is necessary to unpack the mechanisms behind these findings. In particular, how sex of child impacts how mothers and fathers view the nutritional needs of their children and breastfeeding more broadly.