DataBank Indicator

Download Report

There has been substantial progress in recent years in getting mothers in the U.S. to breastfeed their infants, and the latest available national data have met Healthy People 2010 goals, but not those for 2020.

Importance

Breastfeeding provides a critical support for infants’ immunologic, nutritional, physical, and cognitive development.[1] Research shows that breastfeeding is associated with a number of benefits to children, including reduced rates of infectious diseases, sudden infant death syndrome, type 1 and type 2 diabetes, lymphoma, leukemia, Hodgkin’s disease, overweight and obesity. [2],[3] Children who are breastfed during early infancy are less likely to suffer from diarrhea, ear infections, lower respiratory infections, urinary tract infections, and bacterial meningitis. Breast milk may also help protect against allergies and digestive disorders.[4]

Studies of breastfeeding also show it to be associated with decreased rates of adverse health and developmental outcomes later in life. For example, children who were breastfed for 9 months were 30 percent less likely to be overweight later in childhood than were infants who were never breastfed.[5] Mothers who breastfed their children for at least three months were significantly less concerned about their child’s language and motor skill development at age six,  compared with mothers of children who were never breastfed.[6] The benefits of breastfeeding for cognitive development have also been demonstrated into adulthood.  Infants who were breastfed for three months or more had significantly higher scores on assessments of their language and intelligence as adults.[7] Studies demonstrate an association between breastfeeding and improved vision, higher IQ, and better cognitive functioning.[8],[9],[10]

In addition to the benefits to infants, breastfeeding is also associated with positive outcomes for mothers. Studies demonstrate a number of maternal health benefits, including earlier return to pre-pregnancy weight, reduced rates of breast and ovarian cancers, and decreased risk of hip fractures and osteoporosis later in the mother’s life.[11] Breastfeeding mothers also report higher rates of mother-infant attachment and bonding, feelings of maternal empowerment, and confidence.[12]

Trends

For infants born in 2013, 81 percent of mothers reported ever breastfeeding, 52 percent reported still breastfeeding at six months, and 31 percent reported breastfeeding at 12 months. These figures reflect growing proportions of infants who are breastfed.  Between 2000 and 2013, the proportion of infants who continued to be breastfed at twelve months increased by 97 percent (from 16 to 31 percent); the proportion who were breastfed at six months increased by 52 percent (from 34 to 52 percent); and the proportion who were ever breastfed increased by fourteen percent (from 71 to 81 percent).  (Figure 1)

Differences by Race/Hispanic Origin[13]

Infants born in 2013 to black mothers were less likely than infants born to white, Hispanic, Asian, or American Indian mothers to be ever breastfed (66 percent for black mothers, compared with 84 percent for white, 83 percent for Hispanic, 84 percent for Asian, and 68 percent for American Indian mothers), and also less likely than all to be breastfed at six and twelve months.  Asian mothers are more likely than mothers of any group other to breastfeed, by each of the three measures, particularly at six and twelve months. (Figure 2)

Differences by Poverty Status

Infants born in 2013 to mothers living below or near the poverty line were less likely to be breastfed, and less likely to continue to be breastfed, than those in higher-income households.  For example, 73 percent of mothers living below the poverty line breastfed compared to 78 percent of mothers living at 100 to 199 percent of the poverty line, 87 percent of mothers living at 200 to 399 percent of the poverty line, and 92 percent of mothers at 600 percent of the poverty line or greater.  For breastfeeding at twelve months, mothers living at more than 400% of the poverty line breastfed at twice the rates of mothers living at less than the poverty line. (Figure 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 2013 to mothers receiving WIC were less likely to be breastfed at six months, compared with mothers eligible for but not receiving WIC, and mothers not eligible and not receiving WIC (31 percent, compared with 61 and 69 percent, respectively). (Appendix 2) This may reflect the lower incomes of WIC recipients,[14] but may also be related to the considerable subsidies, particularly prior to 2010, that WIC provided for mothers buying formula.[15] This disparity exists for all measured periods. (Appendix 1 and Appendix 3)

Differences by Maternal Education

Mothers who have more education are more likely to breastfeed their infants than are mothers with less education. For infants born in 2013, 92 percent of mothers with a college education ever breastfed their infant, compared with 84 percent of those with some college education, 71 percent for those with a high school degree and 69 percent for those with less than a high school degree. (Appendix 1) Patterns are similar when looking at mothers who breastfed at six months. Seventy percent of mothers with a college education breastfed at six months, compared with 49 percent with some college education, and 39 and 38 percent, respectively, for those with a high school degree and those with less than a high school degree. (Appendix 2) At twelve months, women college graduates were more likely than their peers to breastfeed, at 44 percent, compared with 27, 21, and 22 percent, respectively, among mothers with some college, a high school diploma only, and no high school diploma. (Appendix 3)

Differences by Marital Status

Married mothers are significantly more likely to breastfeed their infants than are non-married mothers.  Eighty-eight percent of infants born in 2013 to married women were ever breastfed, compared with 70 percent born to unmarried mothers. (Appendix 1) The difference was greater for breastfeeding at six and twelve months: married mothers were 29 percentage points more likely than unmarried mothers at six months, and twice as likely as unmarried mothers to still be breastfeeding at twelve months. (Appendix 2 and Appendix 3)

Differences by Maternal Age

Young mothers are substantially less likely than older mothers to breastfeed their infants.  For infants born in 2013, 22 percent of mothers ages 20 to 29 breastfed their infant at twelve months, compared with 37 percent of mothers 30 and older. At six months, mothers between 20 and 29 were also less likely than their older peers to be breastfeeding (41 percent, compared with 60 percent among mothers age 30 and older).  Mothers ever breastfeeding showed a similar pattern, with mothers ages 20 to 29 breastfeeding at 77 percent, compared to 85 percent for mothers age 30 and older. (Figure 4)

State and Local Estimates

State breastfeeding estimates are available from the National Immunization Survey (NIS) for babies born in 2011.

International Estimates

International estimates by country and region can be obtained from UNICEF.

National Goals

The federal Healthy People 2020 initiative has several goals to increase proportion of infants who are breastfed by 2020, including to increase the proportion ever breastfed to 81.9 percent, the proportion breastfed at six months to 60.6 percent, and the proportion breastfed at twelve months to 34.1 percent,.  There are also supporting goals to increase the proportion of employers that have lactation support programs, to reduce the proportion of breastfeeding newborns who receive formula supplementation, and to increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their infants.

More information is available here.  (Goals MICH-21 through MICH-24)

What Works to Make Progress on This Indicator

See: Shealy, K.R., Li, R., Benton-Davis, S., & Grummer-Strawn, L. M. (2005). The CDC Guide to Breastfeeding Interventions.
Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

Also, see Child Trends’ LINKS database (“Lifecourse Interventions to Nurture Kids Successfully”), for reviews of many
rigorously evaluated programs, including the following which has been shown to be effective:

In addition, the U.S. Department of Health and Human Services has published “The Surgeon General’s Call to Action to Support Breastfeeding,” which presents a national plan to promote breastfeeding, based on education, research, awareness, and support. The document is available online.

Related Indicators

Definition

Breastfeeding was defined as the child being fed breast milk 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 reflects the year of the child’s birth, not the survey year. Before 2009, the survey was conducted on land-line phones only, but more recent data were collected from both landlines and cell phones.

Data Source

Data for 2000-2013: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2001–2013, CDC National Immunization Survey. Atlanta, GA: Author. Available online at: www.cdc.gov/breastfeeding/data/NIS_data/index.htm.

Raw Data Source

National Immunization Survey

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

Appendix 1 – Among Infants Born in 2000-2013,1 Percentage of Mothers Ever Breastfeeding2, by Socio-Demographic Factors

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Total 71 72 71 73 73 74 74 76 75 76 77 79 80 81
Sex of Infant
Male 70 72 71 72 73 75 73 75 76 77 80 80 81
Female 71 72 72 73 74 73 75 75 76 77 79 80 81
Birth order
First-born 68 71 71 73 73 74 74 75 75 76 79 79 79
Not first-born 75 73 72 73 73 74 74 76 77 78 80 82 84
Race/Hispanic origin
Non-Hispanic white 72 73 72 74 74 75 74 76 78 79 81 83 84
Non-Hispanic black 48 52 52 54 56 57 56 58 61 63 62 66 66
Hispanic 79 80 79 80 80 81 81 81 80 79 84 82 83
Asian or Pacific Islander 86 77 79 79 81 82 83 83
Non-Hispanic Asian 86 80 91 83 84
Non-Hispanic American Indian or Alaskan Native3 80 69 67 69 75 65 71 74 69 75 77 72 68
Receiving WIC
Yes 62 65 65 65 66 67 67 68 69 69 72 73 74
No, but eligible 83 77 72 76 78 75 74 78 79 81 83 80 82
No, and ineligible 80 80 81 82 82 83 82 85 87 88 90 91 91
Maternal Age
Less than 20 68 59 43 52 54 52 58 60 60 56 67  59  –
Ages 20 – 29 66 68 67 68 69 70 70 70 71 73 74 75 77
30 and older 75 76 77 77 77 78 78 79 81 81 84 84 85
Maternal Education
Less than High School 65 66 64 64 67 66 68 67 67 66 69 69 69
High School 62 64 63 65 65 68 66 66 67 68 69 71 71
Some College 72 74 75 76 75 74 75 77 77 78 81 81 84
College Graduate 83 85 84 84 86 86 86 88 89 90 91 91 92
Maternal Marital Status
Married 76 78 78 78 79 79 80 82 84 85 87 87 88
Unmarried4 59 59 57 60 59 62 60 61 63 64 67 68 70
Income-to-Poverty Ratio5
Less than 100% 61 64 63 63 65 67 66 67 66 68 71 71 73
100% – 199% 76 76 78 79 78
200% – 399% 82 83 86 86 87
400% – 599% 88 86 87 88 90
600% or greater 86 89 91 91 92
1 Before 2009, the survey was conducted on land-line phones only, but more recent data were collected from both landline and cell phone households.

2 Breastfeeding with or without the addition of complementary liquids or solids.

3 Prior to 2009, American Indians or Alaskan Natives included Hispanics.

4 Includes widowed, separated, divorced, deceased, and never married.

5 This equals the ratio of the self-reported family income to the federal poverty threshold value, taking into account the number of people in the household.

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2001–2013, CDC National Immunization Survey. Atlanta, GA: Author. Available online at http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm

Appendix 2 – Among Infants Born in 2000-2013,1 Percentage of Mothers Breastfeeding2 at 6 Months, by Socio-Demographic Factors

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Total 34 37 38 39 42 43 44 44 44 47 48 49 51 52
Sex of Infant
Male 33 36 36 39 41 43 43 43 46 48 50 50 52
Female 36 38 39 39 43 43 44 44 47 48 49 53 52
Birth order
First-born 34 38 38 38 44 45 46 44 48 50 50 53 52
Not first-born 35 35 38 40 40 41 41 42 45 44 48 49 52
Race/Hispanic origin
Non-Hispanic white 38 38 39 41 43 44 45 45 49 49 52 56 58
Non-Hispanic black 18 22 22 25 28 30 29 28 33 36 35 35 39
Hispanic 36 41 42 42 45 46 48 46 47 49 48 51 46
Asian or Pacific Islander 38 42 42 47 52 56 56 56  –  –
Non-Hispanic Asian 65 60 71 66 64
Non-Hispanic American Indian or Alaskan Native3 37 31 30 34 41 35 40 42 39 45 37 29 41
Receiving WIC
Yes 24 30 30 30 34 34 34 34 36 37 38 39 31
No, but eligible 47 51 45 48 52 53 50 48 55 59 56 58 61
No, and ineligible 45 46 49 50 52 53 54 54 62 63 66 68 69
Maternal Age
Less than 20 16 14 13 18 18 19 22 22 20 17 19 17
Ages 20 – 29 27 31 31 32 35 35 34 33 37 38 39 41 41
30 and older 42 44 45 46 49 50 50 51 55 57 59 60 60
Maternal Education
Less than High School 26 32 31 33 37 36 37 37 38 38 34 40 38
High School 26 28 29 29 32 34 34 31 35 37 38 38 39
Some College 35 36 39 40 42 39 42 41 44 41 46 46 49
College Graduate 48 53 52 53 57 59 59 60 65 66 68 70 70
Maternal Marital Status
Married 39 43 44 45 49 50 51 52 57 59 60 62 63
Unmarried4 22 23 24 25 27 28 28 26 29 29 32 33 34
Income-to-Poverty Ratio5
Less than 100% 25 31 30 30 35 36 35 35 36 38 38 38 38
100% – 199% 45 43 46 49 47
200% – 399% 53 55 58 60 60
400% – 599% 61 59 62 66 66
600% or greater 62 65 68 70 70
1 Before 2009, the survey was conducted on land-line phones only, but more recent data were collected from both landline and cell phone households.

2 Breastfeeding with or without the addition of complementary liquids or solids.

3 Prior to 2009, American Indians or Alaskan Natives included Hispanics.

4 Includes widowed, separated, divorced, deceased, and never married.

5 This equals the ratio of the self-reported family income to the federal poverty threshold value, taking into account the number of people in the household.

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2001–2013, CDC National Immunization Survey. Atlanta, GA: Author. Available online at http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm

 

Appendix 3 – Among Infants Born in 2000-2013,1 Percentage of Mothers Breastfeeding2 at 12 Months, by Socio-Demographic Factors

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Total 16 18 19 20 21 22 23 23 23 25 25 27 29 31
Sex of Infant
Male 14 17 18 20 21 22 22 22 24 26 26 28 30
Female 18 19 20 20 22 21 24 23 25 25 28 31 32
Birth order
First-born 17 19 19 19 23 24 25 24 26 28 28 33 36
Not first-born 14 17 19 20 19 18 20 21 22 21 25 17 19
Race/Hispanic origin
Non-Hispanic white 17 19 20 21 21 21 23 23 26 27 28 33 36
Non-Hispanic black 7 9 10 11 13 15 13 13 16 15 16 17 19
Hispanic 17 21 22 22 25 24 26 25 26 27 25 28 26
Asian or Pacific Islander 18 23 25 25 29 32 35 33
Non-Hispanic Asian 35 32 47 42 39
Non-Hispanic American Indian or Alaskan Native3 19 15 16 18 23 15 20 21 23 27 25 18 22
Receiving WIC
Yes 11 15 15 15 17 17 17 18 19 19 20 19 21
No, but eligible 24 28 27 27 31 32 32 31 34 38 33 41 42
No, and ineligible 20 22 25 24 25 26 28 28 32 34 36 42 43
Maternal Age
Less than 20 8 7 5 6 9 9 9 11 11 7 13 4
Ages 20 – 29 11 14 15 15 17 15 17 16 18 18 19 21 22
30 and older 20 22 24 24 25 26 27 27 30 32 34 36 37
Maternal Education
Less than High School 13 17 16 19 20 20 20 22 21 22 20 21 22
High School 12 14 14 14 16 16 17 15 19 21 20 20 21
Some College 14 17 19 19 20 19 22 21 21 18 24 24 27
College Graduate 23 26 27 26 29 30 31 31 35 36 38 43 44
Maternal Marital Status
Married 18 21 23 23 25 25 27 28 31 33 33 38 39
Unmarried4 10 11 11 12 13 13 14 12 14 13 16 15 17
Income-to-Poverty Ratio5
Less than 100% 12 16 16 17 19 19 18 19 19 21 20 20 21
100% – 199% 25 23 25 28 28
200% – 399% 28 29 32 36 37
400% – 599% 31 31 35 38 43
600% or greater 31 35 34 39 42
1 Before 2009, the survey was conducted on land-line phones only, but more recent data were collected from both landline and cell phone households.

2 Breastfeeding with or without the addition of complementary liquids or solids.

3 Prior to 2009, American Indians or Alaskan Natives included Hispanics.

4 Includes widowed, separated, divorced, deceased, and never married.

5 This equals the ratio of the self-reported family income to the federal poverty threshold value, taking into account the number of people in the household.

Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Breastfeeding among U.S. children born 2001–2013, CDC National Immunization Survey. Atlanta, GA: Author. Available online at http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm

Endnotes


[1]Gartner, L.M., & Eidelman, A. (2005). Breastfeeding and the use of human milk. Pediatrics, 115(2), 496-506.

[2]Ibid.

[3]Woo, J. G., Dolan, L. M., Morrow, A. L., Geraghty, S. R., & Goodman, E. (2008). Breastfeeding helps explain racial
and socioeconomic status disparities in adolescent adiposity. Pediatrics, 121(3), e458-e465.

[4]Gartner & Eidelman. (2005). op. cit.

[5]Division of Nutrition and Physical Activity. (2007). Research to practice series no.4: Does breastfeeding reduce the risk of
pediatric overweight? Atlanta, GA: Center for Disease Control and Prevention.

[6]Dee, D. L., Li, R., Lee, L. C., Grummer-Strawn, L. (2007). Associations between Breastfeeding practices and young
children’s language and motor skill development. Pediatrics, 119 (supplement 1), S92-S98.

[7]Mortensen, E. L, Michaelsen, K. F., Sanders, S.A., & Reinisch, J. M. (2002). The association between duration of breastfeeding and adult intelligence. Journal of the American Medical Association, 297(18), 2365-2371.

[8]Golding, J., Rogers, I. S., & Emmett, P. M. (1997). Association between breast feeding, child development and behavior. Early Human Development, 49 (Supplement), S175-S184.

[9]Kramer, M. S, Aboud, F., Mironova, E., Vanilovich, I., Platt, R. W., Matush, L., Igumnov, S., et al. (2008). Breastfeeding and child cognitive development: New evidence from a large randomized trial. Archives of General Psychiatry, 65(5),578-584.

[10]Belfort, M. B., Rifas-Shiman, S. L., Kleinman, K. P., Guthrie, L. B., Bellinger, D. C., Taveras, E. M., Gillman, M. W., & Oken, E. (2013). Infant feeding and childhood cognition at ages 3 and 7 years.  JAMA Pediatrics, published online July 29, 2013.

[11]Gartner, L. M., & Eidelman, A. (2005). Op. cit.

[12]Callen, J., & Pinelli, J. (2005). A review of the literature examining the benefits and challenges, incidence and duration, and barriers to breastfeeding in preterm infants. Advances in Neonatal Care, 5(2),72-88.

[13]Hispanics may be any race. Totals for whites, blacks, Asians, and American Indians in this report exclude Hispanics unless otherwise specified. American Indians include Alaska Natives.

[14]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

[15]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(1 supplement). 632.9.

Suggested Citation:

Child Trends Databank. (2016). Breastfeeding. Available at: https://www.childtrends.org/?indicators=breastfeeding

Last updated: November 2016

Subscribe to Child Trends

Short weekly updates of recent research on children and youth.