15 wic breastfeeding reportbreastfeeding promotion continues to be one of the main goals for the...

BreastfeedingData FY2014

Breastfeeding promotion continues to be one of the main goals for the IndianaWIC Program. The

benefits of breastfeeding extend far beyond basic nutritional value. Its health, immunologic and

economic advantages are widely recognized.

The breastfeeding

initiation rate among the

Indiana WIC Program

population has been

improving steadily over

the last decade, increasing

from 53.6% in 2004 to

71.2% in 2014. This is a

total increase of 17.6%

over the decade including

a 1.5% increase compared

to 2013 (Figure 1).

The breastfeeding initiation rate is increasing across all racial and ethnic groups (Figure 2).

Although the

breastfeeding initiation

rate remains the lowest

among the black WIC

population, this group

experienced the highest

increase compared to

other racial and ethnic

groups, rising by over

20% from 43.2% in

2004 to 63.4% in 2014.

0%

10%

20%

30%

40%

50%

60%

70%

80%

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Figure 1. Indiana WIC Program Trends in

Breastfeeding

Ever Breastfed Breastfed 6 Months Breastfed 12 Months

Source: ISDH WIC Division

0

20

40

60

80

100

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Figure 2. Trends in Breastfeeding Initiation by

Race/Ethnicity

White Black Hispanic

%


%

Compared to all other races/ethnicities, Asian WIC participants had the highest prevalence of

breastfeeding at 3, 6 and 12 months (53.9%, 39.2% and 27.2% retrospectively) (Figure 3).

Over 20% of breastfeeding women in the Indiana WIC Program discontinue breastfeeding only 1

week after initiation and about half of those discontinue breastfeeding after 6 weeks (Figure 4).

0

10

20

30

40

50

White Black Hispanic Asian Multiple Total

Figure 3. Percentage of Infants Breastfed at least

3, 6 and 12 Months by Race and Ethnicity

Breastfed 3 months Breastfed 6 months Breastfed 12 months

%


88.2%

79.3%

71.9% 65.4%

58.5%

50.6% 45.9%

39.1% 33.7%

29.2% 26.3%

18.7% 12.6%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% Figure 4. Prevalence of Breastfeeding Duration among

Ever Breastfed Infants

%

%


The most frequent reason for discontinuing breastfeeding reported by Indiana WIC mothers was

a concern that baby was not getting enough milk (32.7%) (Figure 5). Other commonly reported

reasons include: “Baby too demanding, fussy, not satisfied” (10.0%), “Infant refused

breast/prefers bottle” (7.8%) and “Met breastfeeding goal” (7.7%). The reasons that were

combined under “All Other” category included “Anxiety, Lack of Confidence” (2.0%), Infant

Teething/Biting (1.2%), “Mother Pregnant” (0.9%), and “Lack of Support or Encouragement

(0.4%).

32.7%

16.0%

10.0%

7.8%

7.7%

6.1%

4.8%

4.8%

4.6%

2.8%

2.6%

Not Enough Milk, Milk Not Good Enough

Other / No Answer

Baby Too Demanding, Fussy, Not Satisfied

Infant Refused Breast/Prefers Bottle

Met Breastfeeding Goal (Planned to Wean at This…

Too Time Consuming, Inconvenient, Tiring/Just did…

Breast and Nipple Problems

Returned to Work or School

Medical Reasons, Hospitalization, Disability

Baby Stopped (After 8 Months of Age)

Mother Taking Medication

Figure 5. Reasons Breastfeeding Ceased

Table 1 outlines the prevalence of breastfeeding initiation and breastfeeding duration at 6 and 12

months among Indiana WIC infants by selected characteristics of their mother, such as maternal

age, marital status, education, pre-pregnancy weight, smoking status during pregnancy,

household smoking status, anemia during pregnancy and time of the WIC Program enrollment.

The prevalence of breastfeeding initiation and duration at 3, 6 and 12 months increased

with maternal age, with higher prevalence rates among women 39 years and older. This

group of women had a 73.8% breastfeeding initiation rate and breastfeeding durations

rates of 42.7% at 3 months, 27.0% at 6 months and 16.8% at 12 months.

Married mothers had higher prevalence rates of breastfeeding initiation (77.3% vs.

68.8%), breastfeeding duration at 3 months (39.4% vs. 21.7%), 6 months (26.5% vs.

12.1%) and 12 months (14.5% vs. 5.1%) compared to single mothers.

Mothers with a higher level of education had higher breastfeeding rates, with the greatest

numbers among those with 16 or more years of education.

Mothers who were underweight prior to their pregnancy had the lowest breastfeeding

initiation rate (70.0%), while those who were obese prior to pregnancy had the lowest 3

months (24.6%), 6 months (16.0%) and 12 months (7.0%) breastfeeding duration rates.

Non-smoking mothers and those who came from non-smoking households had higher

breastfeeding initiation and duration rates compared to those who did smoke and came

from smoking households.

Women who were diagnosed with anemia during pregnancy had lower breastfeeding

initiation (67.8% vs. 74.3%), 3 months (22.0% vs. 30.8%), 6 months (13.7% vs. 21.1%)

and 12 months (5.9% vs. 9.6%) duration rates compared to those who did not have

anemia.

Women who were enrolled in WIC in either first or second trimester of pregnancy had

higher breastfeeding initiation and duration rates compared to those who were enrolled in

the third trimester of pregnancy.

Table 1. Prevalence of Breastfeeding Initiation and Duration to 6 and 12 Months among

Indiana WIC Infants by Selected Maternal Characteristics (1, 2)

EVER

BREASTFED

BREASTFED

3 MONTHS

BREASTFED

6 MONTHS

BREASTFED

12 MONTHS

Maternal Age

<15 years 58.3% 9.5% 4.8% 1.6%

15-19 years 71.0% 15.8% 8.2% 3.4%

20-29 years 71.8% 26.0% 15.4% 7.4%

30-39 years 72.9% 39.4% 26.5% 14.0%

39+ years 73.8% 42.7% 27.0% 16.8%

Maternal Marital Status

Single 68.8% 21.7% 12.1% 5.1%

Married 77.3% 39.4% 26.5% 14.5%

Maternal Education

<9 years 72.2% 38.4% 25.5% 14.7%

9-12 years 67.7% 22.0% 12.8% 5.9%

13-15 years 78.5% 33.6% 20.1% 10.0%

16-17 years 87.1% 53.0% 37.0% 20.2%

18+ years 88.1% 56.6% 42.6% 19.5%

Maternal Pre-pregnancy BMI

Underweight 70.0% 27.6% 18.1% 7.4%

Normal Weight 73.6% 29.0% 19.8% 9.3%

Overweight 73.8% 29.3% 20.0% 9.7%

Obese 71.4% 24.6% 16.0% 7.0%

Smoking During Pregnancy

No 75.7% 32.2% 22.2% 10.1%

Yes 60.0% 13.0% 7.1% 2.6%

Household Smoking During

Pregnancy

No 74.4% 31.8% 22.5% 10.2%

Yes 62.3% 17.5% 10.5% 4.5%

Anemia During Pregnancy

No 74.3% 30.8% 21.1% 9.6%

Yes 67.8% 22.0% 13.7% 5.9%

Trimester at Enrollment

1st Trimester 73.8% 27.9% 17.2% 4.5%

2nd Trimester 72.8% 28.0% 17.7% 4.2%

3rd Trimester 69.9% 25.0% 14.5% 3.1%

(1) Reporting period is Oct. 1, 2013 through Sep. 30, 2014. Analyses based one record per child.

(2) Infants born during the reported period included in the Ever Breastfed analysis.

Table 2 identifies the top five Indiana WIC local agencies with the highest prevalence of

breastfeeding initiation and breastfeeding duration at 3, 6 and 12 months. One local agency,

Whitley County WIC Program, has exceeded the Healthy People 2020 objective to increase the

proportion of ever breastfed infants to 81.9% by 3.0%.

Table 2. Prevalence of Breastfeeding Initiation and Breastfeeding Duration to 3, 6 and 12

Months in Top Five Indiana WIC Local Agencies (1, 2)

LOCAL WIC AGENCY AGENCY ID PERCENT

Highest Prevalence of Breastfeeding Initiation

Whitley County WIC Program 53 84.9%

Steuben County WIC Program 50 81.6%

Elkhart County WIC Program 08 80.0%

LaGrange County WIC Program 49 79.9%

Tippecanoe County WIC Program 41 79.7%

Highest Prevalence of Breastfeeding to 3 Months

Johnson County WIC Program 44 33.0%

Elkhart County WIC Program 8 32.2%


Monroe County WIC Program 25 30.9%



Johnson County WIC Program 44 25.6%




Kosciusko County WIC Program 59 21.2%





Hendricks County WIC Program 32 11.1%

Kosciusko County WIC Program 59 10.7%

(1) Reporting period is Oct. 1, 2013 through Sep. 30, 2014. Analyses based one record per child.

(2) Infants born during the reported period included in the Ever Breastfed analysis.

Figure 6. Indiana WIC Breastfeeding Initiation by County

Allen

68.3

Lake

70.2

Knox

57.1

Vigo

65.0

White

79.8

Jay

66.3

Jasper

65.9

Cass

56.6

Clay

75.2

Pike

62.3

Rush

67.5

Parke

62.4

Grant

61.9

Greene

63.7

Perry

51.7

Clark

76.6

Ripley

68.2

Noble

71.6

La Porte

59.2

Gibson

66.7

Porter

75.0

Wells

81.3

Posey

66.7

Elkhart

80.0

Owen

70.0

Henry

78.5

Boone

65.5

Miami

69.2

Jackson

67.5

Putnam

72.4

Dubois

78.7

Shelby

67.5

Pulaski

62.2

Fulton

61.0

Marion

69.6

Wayne

64.8

Clinton

76.8

Sullivan

72.8

Harrison

81.7

Benton

71.8Carroll

68.3

Daviess

69.9Martin

64.3

Orange

85.3

Kosciusko

77.1

Monroe

79.5

Morgan

70.3

Madison

70.6

Marshall

74.7

Newton

42.9

Warrick

66.0

Wabash

68.8

Warren

90.0

Brown

71.4

Franklin

66.3

Adams

81.6

Starke

72.9

Decatur

67.0

Randolph

56.8

Lawrence

77.6

St Joseph

79.0

Whitley

84.9

De Kalb

74.2

Fountain

70.8 Hamilton

79.8

Washington

74.4

Tippecanoe

79.7 Tipton

65.6

Jennings

66.4

Delaware

70.7

Hendricks

76.9

Lagrange

79.9

Montgomery

73.0

Jefferson

72.9

Steuben

81.6

Howard

61.8

Johnson

79.4

Scott

63.9

Hancock

82.4

Crawford

71.8

Bartholomew

69.8

Fayette

64.4Union

63.3

Spencer

50.5

Huntington

74.2

Dearborn

63.5

Floyd

72.4

Vrmn

60.5

Switzerland

64.7

Ohio

33.3

Vander-

burgh69.6

Black-

ford75.3

33.3 - 51.7

51.8 - 71.1

71.2 - 81.8

81.9 - 90.0

State Percent=71.2%(Healthy People 2020 Objective=81.9%)

Figure 7. Indiana WIC Prevalence of Breastfeeding at 3 Months by County

Allen21.7

Lake20.0

Knox16.7

Vigo17.9

White23.7

Jay22.5

Jasper23.8

Cass22.1

Clay22.0

Pike24.6

Rush19.4

Parke24.1

Grant18.0

Greene18.6

Perry18.7

Clark27.0

Ripley19.8

Noble26.7

La Porte19.6

Gibson14.8

Porter26.0

Wells25.4

Posey15.4

Elkhart32.2

Owen21.4

Henry22.5

Boone23.7

Miami22.5

Jackson20.3

Putnam23.1

Dubois25.5

Shelby17.4

Pulaski13.2

Fulton21.5

Marion26.7

Wayne18.7

Clinton22.4

Sullivan24.1

Harrison29.3

Benton32.9

Carroll20.3

Daviess17.4

Martin20.6

Orange25.0

Kosciusko28.8

Monroe34.3

Morgan16.8

Madison20.7

Marshall27.6

Newton5.5

Warrick17.6

Wabash16.2

Warren22.4

Brown39.6

Franklin23.1

Adams28.3

Starke18.6

Spencer14.8

Decatur17.0

Randolph22.6

Lawrence20.3

St Joseph26.5

Whitley31.8

De Kalb27.0

Fountain15.4 Hamilton

36.6

Washington21.6

Tippecanoe30.7

Tipton16.2

Jennings20.8

Delaware19.3

Hendricks25.7

Lagrange28.9

Montgomery23.7

Jefferson21.2

Steuben25.3

Howard18.0

Johnson33.0

Scott16.6

Huntington20.3

Hancock30.0

Crawford23.9

Dearborn18.5

Bartholomew24.3

Fayette16.2

Union21.3

Floyd20.7

Blackford27.2

Verm.17.2

Switzerland11.4

Ohio8.3

Vander-burgh

15.1

5.5 - 16.8

16.9 - 23.8

23.9 - 28.3

28.4 - 39.6

State Percent=23.9%


Allen15.4

Lake13.1

Knox11.1

Vigo11.8

White15.3

Jay14.8

Jasper12.1

Cass14.1

Clay18.3

Pike16.2

Rush13.8

Parke13.6

Grant10.6

Greene11.9

Perry10.0

Clark18.5

Ripley11.2

Noble20.2

La Porte14.2

Gibson10.3

Porter17.8

Wells14.9

Posey7.8

Elkhart20.5

Owen16.2

Henry17.2

Boone19.2

Miami16.9

Jackson13.1

Putnam13.0

Dubois15.7

Shelby12.6

Pulaski15.6

Fulton9.9

Marion18.7

Wayne11.7

Clinton13.1

Sullivan12.3

Harrison12.2

Benton15.0

Carroll13.9

Daviess11.2

Martin9.0

Orange13.9

Kosciusko21.2

Monroe27.0

Morgan9.7

Madison15.1

Marshall19.3

Newton7.0

Warrick13.3

Wabash12.6

Warren13.7

Brown19.2

Franklin17.6

Adams13.1

Starke17.2

Spencer7.5

Decatur10.0

Randolph15.5

Lawrence15.8

St Joseph17.3

Whitley21.9

De Kalb15.9


27.4

Washington15.2

Tippecanoe22.6 Tipton

19.7

Jennings15.1

Delaware13.5

Hendricks20.0

Lagrange17.2

Montgomery13.7

Jefferson12.4

Steuben16.3

Howard12.3

Johnson25.6

Scott11.4

Hancock19.1

Crawford24.6

Bartholomew17.9

Fayette9.1

Union15.2

Huntington11.4

Dearborn11.5

Floyd12.5

Vrmn12.9

Switzerland12.8

Ohio25.0

Vander-burgh11.5

Blackford14.4

7.0 - 12.5

12.6 - 16.3

16.4 - 21.9

22.0 - 27.4



Allen8.3

Jay7.4

Lake5.4

Knox4.6

Vigo4.9

White5.4

Jasper5.3

Cass6.2

Clay6.4

Pike3.9

Rush7.3

Parke6.3

Grant4.6

Greene4.6

Perry4.9

Clark10.1

Ripley5.4

Noble11.5

La Porte6.4

Gibson2.8

Porter7.5

Wells8.8

Posey1.9

Elkhart9.4

Owen6.1

Henry9.0

Boone6.5

Miami5.4

Jackson5.0

Putnam5.4

Dubois7.2

Shelby6.6

Pulaski8.5

Fulton8.0

Marion9.5

Wayne9.3

Clinton6.7

Sullivan3.2

Harrison5.2

Benton7.1

Carroll5.4

Daviess5.8

Martin2.9

Orange9.4

Kosciusko10.7

Monroe15.9

Morgan3.8

Madison9.1

Marshall8.8

Newton2.6

Warrick7.0

Wabash10.0

Warren3.0

Brown15.7

Franklin15.2

Adams4.8

Starke9.2

Spencer1.0

Decatur3.6

Randolph9.6

Lawrence6.8

St Joseph9.1

Whitley12.1

De Kalb5.0


12.4

Washington7.8

Tippecanoe11.9 Tipton

3.3

Jennings4.8

Delaware8.0

Hendricks11.1

Lagrange10.2

Montgomery7.1

Jefferson7.8

Steuben6.2

Howard7.4

Johnson10.1

Scott4.8

Hancock11.5

Crawford11.3

Bartholomew8.3

Fayette5.0

Union13.6

Huntington5.8

Dearborn5.0

Floyd6.0

Vrmn9.6

Switzerland8.6

Ohio5.9

Vander-burgh

5.0

Blackford9.9

1.0 - 5.0

5.1 - 8.0

8.1 - 10.7

10.8 - 15.9


15 wic breastfeeding reportbreastfeeding promotion continues to be one of the main goals for the...

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