Breast-feeding practices among WIC participants in Hawaii

Objective To describe breast-feeding practices and identify correlates of breast-feeding among participants in the Hawaii Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program. Design A cross-sectional survey. Subjects/setting We conducted structured, in-person interviews with 535 women at WIC clinics throughout Hawaii (95% response rate). The interview collected information on maternal characteristics and infant-feeding practices. Statistical analyses Breast-feeding prevalence was examined by infant age and predictors of infant-feeding method were examined via bivariate tests and multivariable logistic regression analysis. Reported breast-feeding promotion efforts in health care settings outside of WIC were also examined. Results Most women (82%) attempted to breast-feed, albeit for short durations for many women; of the women who breast-fed in combination with formula feeding, 46% introduced formula within the first week after delivery. Significant predictors of breast-feeding initiation included previous breast-feeding experience, having a close relative or friend who breast-fed, multiparity, Asian/Pacific Island ethnicity (other than Filipino), and being foreign-born. Significant predictors of mixed feeding (vs exclusive breastfeeding) included working or attending school, age less than 20 years, Hawaiian/part Hawaiian or Filipino ethnicity, being Hawaiian-born, and residing in Oahu county. Conclusions Although most women in this population initiated breast-feeding, formula was usually introduced at an early age. This study identified several factors associated with breast-feeding initiation and exclusive breast-feeding, factors that may prove useful for the development of appropriate interventions to promote these behaviors.