The Interaction of Race and Pregnancy Intentions on Breastfeeding Initiation Rates and Duration in the United States

Background: Unintended pregnancy increases adverse perinatal health outcomes. Limited studies exist on the influence of pregnancy intention on breastfeeding. This study examines the interaction of Race and couples' pregnancy intention on breastfeeding initiation and duration. Methods: Using the National Survey of Family Growth (2017-2019), we categorized breastfeeding into three categories (never breastfed, breastfed for 6 months or less, and breastfed for more than 6 months). Multinomial logistic regression and probability marginal effects were estimated across racial categories (Hispanics, non-Hispanic [NH] White, Black, and NH-others or multiracial). Results: The probability (Pr.) of never breastfeeding was the greatest among NH-Black women for all pregnancy intentions-both intended (Pr.: 0.34), mother-only (Pr.: 0.27), father-only (Pr.: 0.45), ambivalent (Pr.: 0.55), and neither intended (Pr.: 0.37). The probability of breastfeeding for 6 months or less is highest for Hispanics for both intended (Pr.: 0.41), NH-White for mother-only intended (Pr.: 0.49), Hispanics for father-only intended (Pr.: 0.56), ambivalent pregnancy intentions (Pr.: 0.60), and NH-others or multiracial for neither intended pregnancies (Pr.: 0.48). The probability of breastfeeding for more than 6 months is highest for NH-others or multiracial for both intended (Pr.: 0.50), ambivalent (Pr.: 0.49), and neither intended (Pr.: 0.36), while highest for NH-Black for mother-only intended (Pr.: 0.43). Conclusions: Our study demonstrates the interaction of Race and couples' pregnancy intention on breastfeeding initiation and duration. Owing to the high volume of unintended pregnancies in the United States, the current study might help maternal and child healthcare providers understand the interaction between race and pregnancy intentions on breastfeeding initiation and duration in the United States.