Provider encouragement of breast-feeding: Evidence from a national survey

Objective: To examine the influence of provider encouragement on breast-fee ding among women of different social and ethnic backgrounds in the United S tates. Methods: A nationally representative sample of 2017 parents with children y ounger than 3 years was surveyed by telephone. The responses of the 1229 wo men interviewed were included in the analysis. Respondents were asked to re call whether their physicians or nurses had encouraged or discouraged them from breast-feeding. The effects of provider encouragement on breast-feedin g initiation and duration were evaluated by multivariate logistic regressio n. The sample was then stratified to allow subset analyses by race and ethn icity, education, income class, age group, and marital status. Results: More than one-third (34.4%) of respondents did not initiate breast -feeding. Three-fourths (73.2%) of women reported having been encouraged by their physicians or nurses to breast-feed; 74.6% of women who were encoura ged initiated breast-feeding, compared with only 43.2% of those who were no t encouraged (P < 0.001). Women who were encouraged to breast-feed were mor e than four times (relative risk 4.39; 95% confidence interval 2.96, 6.49) as likely to initiate breast-feeding as women who did not receive encourage ment. The influence of provider encouragement was significant across all st rata of the sample. In populations traditionally less likely to breast-feed , provider encouragement significantly increased breast-feeding initiation, by more than threefold among low-income, young, and less-educated women; b y nearly fivefold among black women; and by nearly Ii-fold among single wom en. Conclusion: Provider encouragement significantly increases breast-feeding i nitiation among American women of all social and ethnic backgrounds. (Obste t Gynecol 2001;97: 290-5. (C) 2001 by The American College of Obstetricians and Gynecologists.).