THURS-014 - Determinants of Breastfeeding Continuation During the Pandemic Among Culturally and Linguistically Diverse Postpartum Women

Brief Abstract Summary: Explore the determinants of breastfeeding continuation during the COVID-19 pandemic among a culturally and linguistically diverse sample of postpartum women obtaining care at a safety-net clinic in Phoenix, AZ. Breastfeeding offers a multitude of physical, mental, and developmental health benefits for both infants and mothers; however, many women struggle to breastfeed for the recommended duration due to economic, societal, physical, or emotional challenges, which COVID-19 dramatically exacerbated. Our survey of women across six ethnolinguistic groups (n=140) found that refugees (compared to US-born and immigrant women) and those who wore masks were significantly more likely to continue breastfeeding (p < 0.05); age, breastfeeding support, and self-reported coping with breastfeeding were marginally significant predictors of continuation (p < 0.1). This research addresses the lack of breastfeeding information during the pandemic and offers insights for improving breastfeeding continuation.

Detailed abstract description: Explore the determinants of breastfeeding continuation during the COVID-19 pandemic among a culturally and linguistically diverse sample of postpartum women (n=140 including U.S.-born, refugees, and immigrants) obtaining care at a safety-net clinic in Phoenix, AZ. Breastfeeding offers physical and mental health benefits for both infants and mothers. Still, despite these benefits, many women struggle to breastfeed for the recommended duration due to economic, societal, physical, or emotional challenges, and COVID-19 exacerbated these challenges. Breastfeeding trends vary in the United States by ethnic and immigrant backgrounds, with breastfeeding initiation and continuation traditionally higher for mothers born outside of the United States. Due to variation in breastfeeding, it is important to study the pandemic and associated variables’ impact on breastfeeding continuation, especially pertaining to refugee and immigrant population experiences. This session describes one portion of the results of a mixed-methods COVID-19 postpartum study that captured women’s close- and open-ended responses to questions about their pregnancy, healthcare, birth outcomes, and breastfeeding experiences during the COVID-19 pandemic at a local clinic using cultural navigators. We used Cox proportional hazard modeling to capture breastfeeding time to stop based on the survey date and infant’s age and provide insight into factors (e.g., age, immigrant status, breastfeeding support, self-reported ability to cope with breastfeeding, mask-wearing during breastfeeding, and anxiety/depression as assessed by PHQ-4 scores) that contributed to continuation or discontinuation. The results of this study show that refugees and those who wore a mask while breastfeeding were significantly more likely to continue breastfeeding (p < 0.05; 79% and 69%, respectively). Marginally significant factors (p < 0.1) that were associated with breastfeeding continuation were the mother’s age (with every year increase, a mother was more likely to continue by 0.05%), breastfeeding support (with a one-unit increase in support, mothers were 18% more likely to continue), and self-reported coping (with agreement on successfully coping with breastfeeding, mothers were 69% more likely to continue). Some of these findings align with prior breastfeeding literature, while others like mask-wearing deserve further investigation. This study can lead to practical insights such as targeted messaging for ethnolinguistic groups and increased support for postpartum women for promoting increased length of breastfeeding for women in the United States, especially for immigrants and refugees.