Interracial couples and breastfeeding initiation in the United States.

In the past decade, the prevalence of interracial couples has steadily increased. Recent reports state that nearly one in five marriages are between spouses of different races. Interracial couples receive less social support and are more likely to separate. As a result, children born to these couples may be at an increased risk of poor health outcomes. This study aims to investigate the relationship between interracial couples and breastfeeding initiation. Data from the 2014 Vital Statistics Natality Birth database were analyzed. Data were restricted to singleton births and infants with no congenital malformations. Racial composition of parents was categorized as non-Hispanic (NH) white, NH black; Hispanic; NH white/NH black; NH white/Hispanic; and NH black/Hispanic. Breastfeeding initiation (yes; no) was categorized according to information from the child's birth certificate file. Multiple logistic regression was used to generate crude and adjusted odds ratios and 99% confidence intervals. After adjusting for confounders, all interracial couples with at least one Hispanic parent had increased odds of breastfeeding initiation. Interracial white and black parents had 18% lower odds of breastfeeding initiation. The lowest odds of breastfeeding initiation were observed among intraracial black parents, who had 43% lower odds of breastfeeding initiation compared to intraracial white parents. Breastfeeding non-initiation continues to pose the greatest risk for infants with at least one black parent. Nurses, midwives, physicians, and other medical staff should discuss potential barriers that may be unique to interracial couples and provide additional breastfeeding education and support.

The Role of Paternity Acknowledgment in Breastfeeding Noninitiation.

BACKGROUND: In the United States, less than a quarter of mothers breastfeed in accordance with national recommendations. To date, researchers have demonstrated that paternal support directly influences breastfeeding outcomes; however, healthcare practitioners may not be able to quantify a lack of support in the immediate postpartum period. Research aim: The aim is to investigate the relationship between breastfeeding noninitiation and paternity acknowledgment, a factor that can be easily identified in the immediate postpartum period. METHODS: Data from the 2014 Vital Statistics Natality Birth database were analyzed. Analysis included primiparous singleton births with no health complications ( N = 1,127,861). Based on the birth certificate data, paternity acknowledgment was categorized as married with paternity acknowledged, unmarried with paternity acknowledged, and unmarried without paternity acknowledged. Breastfeeding initiation was dichotomized (yes or no). Multiple logistic regression analyses were conducted to obtain crude and adjusted odds ratios and 99% confidence intervals (α = .01). RESULTS: Approximately one in seven births had no paternity acknowledgment on their birth certificate. After adjusting for confounders, mothers who were not married but the paternity of the infant was acknowledged had 50% higher odds of breastfeeding noninitiation compared with mothers who were married and their infants' paternity was acknowledged (adjusted odds ratio = 1.50, 99% confidence interval [1.47, 1.53]). Furthermore, women who were unmarried and without paternity acknowledgment had 135% higher odds of breastfeeding noninitiation compared with married women with paternity acknowledgment (adjusted odds ratio = 2.35, 99% confidence interval [2.30, 2.41]). CONCLUSION: Women whose births were not acknowledged by the fathers may need additional breastfeeding support from healthcare practitioners.

Associations of Partner Age Gap at Sexual Debut with Teenage Parenthood and Lifetime Number of Partners.

CONTEXT: Age at sexual debut and age gap between partners at debut are modifiable characteristics that may be related to risky sexual behaviors. Understanding any such relationships is a necessary first step toward strengthening risk interventions. METHODS: Age at sexual debut and partner age gap were examined for 3,154 female and 2,713 male respondents to the 2011-2013 National Survey of Family Growth who first had intercourse before age 18. Multivariable logistic regression was used to assess associations between these measures and teenage parenthood and reporting a high lifetime number of partners (i.e., a number above the sample median). RESULTS: Females' odds of teenage parenthood were elevated if sexual debut occurred at ages 15-17 and involved a partner age gap of 3-4 years (odds ratio, 1.8) or more (2.0); they were reduced if debut occurred before age 15 and the gap was 3-4 years (0.8). Females' likelihood of reporting a high lifetime number of partners was negatively associated with age gap (0.4-0.7, depending on age at debut and length of age gap). Males' likelihood of reporting a large number of partners was positively associated with age gap if sexual debut was before age 15 and the gap was five or more years (1.7) or if debut was at ages 15-17 and involved a 3-4-year gap (2.0). CONCLUSION: Identifying the mechanisms underlying these associations could inform program design and implementation.