Breastfeeding

Publication Date:

Dec 27, 2018

Key facts about breastfeeding

  • Breastfeeding rates continue to rise; for infants born in 2014, rates of breastfeeding ever and at 12 months met the Healthy People 2020 goals (83 and 34 percent, respectively, compared with goals of 82 and 34 percent).[1]
  • Infants born to households living in poverty are much less likely to have ever been breastfed than those in households above the federal poverty line (FPL); for infants born in 2014, 73 percent of those in households below the FPL had ever been breastfed, compared with 93 percent in households with incomes from 400 to 599 percent of the FPL.
  • Parents who are younger, unmarried, receiving WIC benefits, or have lower educational attainment report lower rates of breastfeeding.

Trends in breastfeeding

For infants born in 2014, 83 percent of parental respondents[2] reported ever breastfeeding, 55 percent reported still breastfeeding at six months, and 34 percent reported breastfeeding at 12 months. These figures reflect growing proportions of infants who are breastfed. For babies born from 2000 to 2014, the proportion of infants who continued to be breastfed at twelve months more than doubled (from 16 to 34 percent); the proportion who were breastfed at six months increased by 62 percent (from 34 to 55 percent); and the proportion who were ever breastfed increased by 17 percent (from 71 to 83 percent) (appendices 1 to 3).

Differences by race/Hispanic origin*

Non-Hispanic black infants born in 2014 were less likely to have ever been breastfed (68 percent) than their non-Hispanic white, Hispanic, non-Hispanic Asian, or non-Hispanic American Indian/Alaska Native counterparts (86, 85, 81, and 80 percent, respectively). Non-Hispanic black infants also had lower rates of breastfeeding at 6 and 12 months than the other racial/ethnic groups; non-Hispanic white and non-Hispanic Asian infants were most likely to continue breastfeeding during this period (appendices 1 to 3).

*Hispanic infants may be of any race. Totals for white, black, Asian, and American Indian infants in this report exclude Hispanic infants unless otherwise specified. American Indian totals include Alaska Native infants.

Differences by poverty status

Infants born in 2014 to households with incomes below or near the federal poverty line (FPL) were ever breastfed at lower rates than those in higher-income households. For example, 73 percent of households below the FPL ever breastfed their infants, compared with 82 percent at 100 to 199 percent of the FPL, 85 percent at 200 to 399 percent of the FPL, 93 percent at 400 to 599 percent of the FPL, and 92 percent of households at 600 percent of the FPL or greater. For breastfeeding at twelve months, households with incomes more than 600 percent of the FPL breastfed their babies at almost twice the rates of households making less than the FPL (45 percent and 26 percent, respectively) (appendices 1 to 3).

Differences by receipt of WIC benefits

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) actively promotes breastfeeding among postpartum women. However, infants born in 2014 to parental respondents receiving WIC benefits were less likely to be ever breastfed than respondents eligible for but not receiving benefits, and respondents not eligible and not receiving WIC benefits (76 percent, compared with 83 and 92 percent, respectively) (Appendix 1). This may reflect the lower incomes of WIC recipients,[3] but may also be related to the considerable subsidies—particularly prior to 2010—that WIC provided for mothers buying infant feeding formula.[4] This disparity exists for all measured periods (appendices 1 to 3).

Differences by maternal education

Infants born to mothers who have more education are breastfed at higher rates than those born to mothers with less education. For infants born in 2014, 92 percent whose mothers had a college education were ever breastfed, compared with 83 percent of those born to mothers with some college education and 73 percent of those whose mothers had a high school degree or less (Appendix 1). Patterns are similar for breastfeeding at six months. Around 73 percent of infants whose mothers had a college education were breastfed at six months, compared with 52 percent of those born to mothers with some college education, and 41 and 42 percent, respectively, for those born to mothers with a high school degree and those with less than a high school degree (Appendix 2). At twelve months, infants born to mothers who are college graduates were breastfed at higher rates (around 46 percent, compared with 30, 23, and 27 percent, respectively, for infants born to mothers with some college, a high school diploma only, and no high school diploma) (Appendix 3).

Differences by marital status

Infants born to married parents are more likely to be breastfed than those born to unmarried parents. Among infants born in 2014, around 89 percent with married parents were ever breastfed, compared with 73 percent born to unmarried parents. This difference was greater for breastfeeding at six and twelve months: Around 66 percent of infants born to married parents were breastfed at six months, versus 37 percent of infants born to unmarried parents. Around 41 percent of infants born to married parents were breastfed at twelve months, versus 21 percent of infants born to unmarried parents  (appendices 1 to 3).

Differences by maternal age

Infants born to older mothers are more likely to be breastfed than infants born to young mothers. In 2014, 85 percent of infants born to mothers ages 30 and older were breastfed, compared to 79 percent of those born to mothers ages 20 to 29. At six months, infants born to mothers ages 30 and older were also more likely than those born to mothers ages 20 to 29 to be breastfed (62 versus 45 percent, respectively). Around 39 percent of infants born to mothers ages 30 and older were breastfed at twelve months, compared with 25 percent of those born to mothers ages 20 to 29 (appendices 1 to 3).

Other estimates

State and local estimates

State breastfeeding rate estimates are available from the National Immunization Survey (NIS) for babies born in 2014 at https://www.cdc.gov/breastfeeding/data/reportcard.htm.

International estimates

International estimates of breastfeeding rates by country and region can be obtained from UNICEF at https://data.unicef.org/wp-content/uploads/2018/05/180509_Breastfeeding.pdf.

Data and appendices

Data source

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017). Breastfeeding among U.S. children born 2002–2014, CDC National Immunization Survey. Atlanta, GA: Author. Retrieved from https://www.cdc.gov/breastfeeding/data/nis_data/results.html.

Raw data source

National Immunization Survey.

http://www.cdc.gov/vaccines/imz-managers/nis/about.html

Appendices

Appendix 1. Among Infants Born in 2000–2014, Percentage Ever Breastfed, by Selected Characteristics

Appendix 2. Among Infants Born in 2000–2014, Percentage Breastfeeding at 6 Months, by Selected Characteristics

Appendix 3. Among Infants Born in 2000–2014, Percentage Breastfeeding at 12 Months, by Selected Characteristics

Background

Definition

Breastfeeding is defined as a child being fed breastmilk directly from the mother, or milk that was pumped from the mother’s breast, with or without the addition of complementary liquids or solids. Yearly data reflect the year of the child’s birth, not the survey year. Before 2009, the survey was conducted on landline phones only, but more recent data were collected from both landlines and cell phones.

Endnotes

[1] U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2018). 2020 topics & objectives: Maternal, infant, and child health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives.

[2] Questions regarding breastfeeding are asked of all parents of a child 19 to 35 months old.

[3] Bitler, M., Gundersen, C., & Marquis, G. S. (2005). Are WIC nonrecipients at less nutritional risk than recipients? An application of the food security measure. Review of Agricultural Economics, 27(3), 433-438.

[4] Reat, A., Crixell, S., Von Bank, J., Thornton, H., & Friedman, B. J. (2014). Average infant formula and breastmilk intake among WIC infants reflects food package changes. The FASEB Journal, 28(Supplement 1), 632–639.

Citation

Child Trends Databank. (2018). Breastfeeding. Available at: https://www.childtrends.org/?indicators=breastfeeding