Birth Order and Breastfeeding Initiation: Results of a National Survey

Background: Because of numerous health benefits for both mothers and babies, breastfeeding is the recommended method of infant feeding. We sought to determine the association between birth order and breastfeeding practices in families with multiple children. Methods: The 2002 National Survey of Family Growth was used to analyze the demographic characteristics of a national probability sample of 2,115 U. S. mothers aged 15 to 44 with two, three, four, and five or more children younger than age 19. In-person, computer-assisted interviews were conducted by trained female interviewers. The main variable of interest was birth order; the main outcome measure was breastfeeding initiation for each mother-child pair. We used multiple logistic regression models to determine the demographic predictors of breastfeeding the second child in families with two children. Results: Mothers with two, three, four, and five or more children breastfed all of their children 52.6%, 48.4%, 44.7%, and 57.1% of the time, respectively (p = 0.46). In families with multiple children, more than 70% of women made the same feeding choice for each of their children, whether it was breastfeeding or bottlefeeding. After controlling for demographic factors, Hispanic women and women with more than a high school education were significantly more likely to breastfeed their second child if they had breastfed the first child. Conclusion: U.S. mothers are likely to choose the same feeding method for each of their children, independent of the number of children they have. Breastfeeding promotion must take into consideration previous infant feeding experiences, if any.