Original Article
“Las Dos Cosas,” or Why Mexican American Mothers Breast-Feed, But Not for Long
Abstract
Objectives: To determine why mothers in El Paso, Texas, choose to breast-feed but not exclusively and why breast-feeding duration is short.Methods: This was a cross-sectional observational study of 300, mostly Mexican American, low-income mothers delivering at a county hospital who answered questions about breast-feeding and formula feeding, sociodemographics, and health habits.
Results: Most mothers (92.6%) in our study initiated breast-feeding, but only 20.3% breast-fed exclusively at the time of hospital discharge. Most mothers (73%) self-identified as Mexicans or Mexican Americans living on the border of the United States and Mexico. Mothers in our study chose to breast-feed if they decided to breast-feed during pregnancy, had breast-fed a previous child, had support from a female relative, and had attended college. Distinctively, most mothers in our study chose “las dos cosas” or to breast-feed and formula feed together early after birth. Acculturation failed to explain the breast-feeding decisions.
Conclusions: Mexican American mothers who decided to breast-feed during pregnancy, breast-fed another child, attended college, and enlist a female relative’s breast-feeding help were more likely to choose breast-feeding exclusively. Most Mexican American low-income mothers in our study chose “las dos cosas.”
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References
1. Hamosh M. Bioactive factors in human milk. Pediatr Clin North Am 2001;48:69-86.
2. Labbok MH. Effects of breast-feeding on the mother. Pediatr Clin North Am 2001;48:143-158.
3. Labbok MH, Clark D, Goldman AS. Breast-feeding: maintaining an irreplaceable immunological resource. Nat Rev Immunol 2004;4:565-572.
4. Bartick M. Breast-feeding and the U.S. economy. Breast-feed Med 2011;6:313-318.
5. Gartner LM, Morton J, Lawrence RA, et al. Breast-feeding and the use of human milk. Pediatrics 2005;115:496-506.
6. World Health Organization. Exclusive breast-feeding for six months best for babies everywhere. http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/. Published January 2011.
7. Centers for Disease Control and Prevention. Breast-feeding Report Card. http://www.cdc.gov/breastfeeding/pdf/2014breastfeedingreportcard.pdf. Published 2014. Accessed October 22, 2015.
8. Centers for Disease Control and Prevention. Racial and ethnic differences in breast-feeding initiation and duration, by state--National Immunization Survey, United States, 2004Y2008. MMWR Morb Mortal Wkly Rep 2010;59:327-334.
9. Practicas de Alimentacion Infantil en Ninos Menores de Dos Anos. Instituto Nacional de Salud Publica: Cuernavaca, Mexico; 2012.
10. Anchondo I, Akins R. Breast-feeding on the US-Mexico border. El Paso Physician 2008;31:5-7.
11. US Department of Health and Human Services. Healthy People 2020: maternal, infant, and child health objectives. https://www.healthypeople.gov. Accessed December 17, 2014.
12. Fein SB, Labiner-Wolfe J, Shealy KR, et al. Infant Feeding Practices Study II: study methods. Pediatrics 2008;122(Suppl 2):S28-S35.
13. Robbins AS, Chao SY, Fonseca VP. What’s the relative risk? A method to directly estimate risk ratios in cohort studies of common outcomes. Ann Epidemiol 2002;12:452-454.
14. Spiegelman D, Hertzmark E. Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol 2005;162:199-200.
15. Centers for Disease Control and Prevention. Rates of any and exclusive breast-feeding by socio-demographics among children born in 2011 (percentage half 95% confidence interval). http://www.cdc.gov/breastfeeding/data/nis_data/rates-any-exclusive-bf-socio-dem-2011.htm. Published 2011. Accessed September 29, 2014.
16. Centers for Disease Control and Prevention. Breast-feeding among U.S. children born 2001-2011, CDC National Immunization Survey. Published 2014. Accessed November 25, 2014.
17. Rassin DK, Richardson CJ, Baranowski T, et al. Incidence of breastfeeding in a low socioeconomic group of mothers in the United States: ethnic patterns. Pediatrics 1984;73:132-137.
18. Deleted in proo.
19. Bunik M, Clark L, Zimmer LM, et al. Early infant feeding decisions in low-income Latinas. Breast-feed Med 2006;1:225-235.
20. Bartick M, Reyes C. Las dos cosas: an analysis of attitudes of Latina women on non-exclusive breast-feeding. Breast-feed Med 2012;7:19-24.
21. Flaherman VJ, Aby J, Burgos AE, et al. Effect of early limited formula on duration and exclusivity of breast-feeding in at-risk infants: an RCT. Pediatrics 2013;131:1059-1065.
22. Mother and Child Health and Education Trust. Ten steps to successful breast-feeding. http://www.tensteps.org. Accessed December 17, 2014.
23. Gill SL, Reifsnider E,Mann AR, et al. Assessing infant breast-feeding beliefs among low-income Mexican Americans. J Perinat Educ 2004;13:39-50.
24. Guttman N, Zimmerman DR. Low-income mothers’ views on breastfeeding. Soc Sci Med 2000;50:1457-1473.
25. Zimmerman DR, Guttman N. ‘‘Breast is best’’: knowledge among low-income mothers is not enough. J Hum Lact 2001;17:14-19.
26. Gill SL. Breast-feeding by Hispanic women. J Obstet Gynecol Neonatal Nurs 2009;38:244-252.
27. Balcazar H, Trier CM, Cobas JA. What predicts breast-feeding intention in Mexican-American and non-Hispanic white women? Evidence from a national survey. Birth 1995;22:74-80.
28. Holbrook KE, White MC, Heyman MB, et al. Maternal sociodemographic characteristics and the use of the Iowa Infant Attitude Feeding Scale to describe breast-feeding initiation and duration in a population of urban, Latina mothers: a prospective cohort study. Int Breast-feed J 2013;8:7.
29. Nommsen-Rivers LA, Chantry CJ, Cohen RJ, et al. Comfort with the idea of formula feeding helps explain ethnic disparity in breast-feeding intentions among expectant first-time mothers. Breast-feed Med 2010;5:25-33.
30. Gorman T, Byrd T, VanDerslice J. Breast-feeding practices, attitudes, and beliefs among Hispanic women and men in a border community. Family Community Health 1995;18:17-27.
31. Guerrero ML, Morrow RC, Calva JJ, et al. Rapid ethnographic assessment of breast-feeding practices in periurban Mexico City. Bull World Health Organ 1999;77:323-330.
32. Li R, Fein SB, Chen J, et al. Why mothers stop breast-feeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics 2008;122(Suppl 2):S69-S76.
33. Haughton J, Gregorio D, Perez-Escamilla R. Factors associated with breastfeeding duration among Connecticut Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants. J Hum Lact 2010;26:266-273.
34. Bunik M, Shobe P, O’Connor ME, et al. Are 2 weeks of daily breast-feeding support insufficient to overcome the influences of formula? Acad Pediatr 2010;10:21-28.
35. Baranowski T, Bee DE, Rassin DK, et al. Social support, social influence, ethnicity and the breast-feeding decision. Soc Sci Med 1983;17:1599-1611.
36. Lee HJ, Rubio MR, Elo IT, et al. Factors associated with intention to breastfeed among low-income, inner-city pregnant women. Matern Child Health J 2005;9:253-261.
37. Sussner KM, Lindsay AC, Peterson KE. The influence of acculturation on breast-feeding initiation and duration in low-income women in the US. J Biosoc Sci 2008;40:673-696.
38. Kimbro RT, Lynch SM, McLanahan S. The influence of acculturation on breast-feeding initiation and duration for Mexican-Americans. Popul Res Policy Rev 2008;27:183-199.
39. Rassin DK, Markides KS, Baranowski T, et al. Acculturation and breastfeeding on the United States-Mexico border. Am J Med Sci 1993;306:28-34.
40. Rice A. Life on the line. http://www.nytimes.com/2011/07/31/magazine/life-on-the-line-between-el-paso-and-juarez.html?_r=0. Published July 28, 2011. Accessed October 23, 2015.
