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Disaggregation of Breastfeeding Initiation Rates by Race and Ethnicity — United States, 2020–2021
ORIGINAL RESEARCH — Volume 20 — December 14, 2023
PEER REVIEWED
Of the 7,289,754 infants born in the US between January 1, 2020, and December 31, 2021, we excluded 83,549 infants who were transferred and 15,648 infants who were not alive at completion of the birth certificate, leaving 7,190,557 infants who were alive and had not been transferred. Of these, 1,086,620 infants had incomplete breastfeeding initiation data (California and Michigan births) and 6,103,937 infants had complete breastfeeding data. An additional 31,183 infants had missing or unknown maternal ethnicity, and 110,621 infants were missing covariate data. In total, 5,962,133 infants had complete data.
Figure 1.
Flow of participants in an analysis of disaggregated breastfeeding initiation rates by race and ethnicity, United States, 2020–2021, using National Vital Statistics System birth certificate data from 2020–2021 US births. Source: National Vital Statistics System (19).
Figure 2.
Breastfeeding initiation by maternal racial groups, with disaggregation of Asian and Native Hawaiian or Other Pacific Islander subgroups, for 48 states and the District of Columbia, 2020–2021. Two states were excluded: California, because breastfeeding data are not reported to NCHS, and Michigan, because data are collected inconsistently. Source: National Vital Statistics System (19).
| Race | Subgroup estimate | Group average | Overall prevalence |
|---|---|---|---|
| Japanese | 94.0 | 90.1 | 84.1 |
| Korean | 93.7 | 90.1 | 84.1 |
| Asian Indian | 93.4 | 90.1 | 84.1 |
| Filipino | 91.3 | 90.1 | 84.1 |
| Vietnamese | 89.3 | 90.1 | 84.1 |
| Chinese | 89.0 | 90.1 | 84.1 |
| Other Asian | 84.2 | 90.1 | 84.1 |
| White | Not applicable | 85.9 | 84.1 |
| >1 race | Not applicable | 83.1 | 84.1 |
| Hawaiian | 84.3 | 80.7 | 84.1 |
| Guamanian or Chamorro | 83.5 | 80.7 | 84.1 |
| Samoan | 81.2 | 80.7 | 84.1 |
| Other Pacific Islander | 79.4 | 80.7 | 84.1 |
| American Indian or Alaskan Native | Not applicable | 77.7 | 84.1 |
| Black or African American | Not applicable | 74.5 | 84.1 |
Figure 3.
Breastfeeding initiation by maternal ethnicity groups, with disaggregation of Hispanic ethnicity subgroups, for 48 states and the District of Columbia, 2020-2021. Two states were excluded: California, because breastfeeding data are not reported to NCHS and Michigan, because data are collected inconsistently. Source: National Vital Statistics System (19).
| Hispanic ethnicity | Subgroup | Group Average | Overall average |
|---|---|---|---|
| Cuban | 90.9 | 86.8 | 84.0 |
| Central or South American | 88.2 | 86.8 | 84.0 |
| Dominican | 88.1 | 86.8 | 84.0 |
| Mexican | 86.9 | 86.8 | 84.0 |
| Other and Unknown Hispanic Origin | 85.8 | 86.8 | 84.0 |
| Puerto Rican | 82.2 | 86.8 | 84.0 |
| Non-Hispanic | Not applicable | 83.2 | 84.0 |
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