Breast-feeding practices among WIC participants in Hawaii

Objective To describe breast-feeding practices and identify correlates of b reast-feeding among participants in the Hawaii Special Supplemental Nutriti on Program for Women, Infants, and Children (WIC) program. Design A cross-sectional survey. Subjects/setting We conducted structured, in-person interviews with 535 wom en at WIC clinics throughout Hawaii (95% response rate). The interview coll ected information on maternal characteristics and infant-feeding practices. Statistical analyses Breast-feeding prevalence was examined by infant age a nd predictors of infant-feeding method were examined via bivariate tests an d multivariable logistic regression analysis. Reported breast-feeding promo tion efforts in health care settings outside of WIC were also examined. Results Most women (82%) attempted to breast-feed, albeit for short duratio ns for many women; of the women who breast-fed in combination with formula feeding, 46% introduced formula within the first week after delivery. Signi ficant predictors of breast-feeding initiation included previous breast-fee ding experience, having a close relative or friend who breast-fed, multipar ity, Asian/Pacific Island ethnicity (other than Filipino), and being foreig n-born. Significant predictors of mixed feeding (vs exclusive breastfeeding ) included working or attending school, age less than 20 years, Hawaiian/pa rt Hawaiian or Filipino ethnicity, being Hawaiian-born, and residing in Oah u county. Conclusions Although most women in this population initiated breast-feeding , formula was usually introduced at an early age. This study identified sev eral 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.