15 Breastfeeding report cover

Breastfeeding Data FY2015

Breastfeeding promotion continues to be one of the main goals for the Indiana State Department

of Health Women, Infants and Children (WIC) 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 58.4%

in 2006 to 72.9% in

2015. This is a total

increase of 14.5% over

the decade including a

1.7% increase

compared to 2014

(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

consistent increase over the

decade, rising by over 16%

from 49.3% in 2006 to

65.6% in 2015.

0.0%

20.0%

40.0%

60.0%

80.0%

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Figure 1. Indiana WIC Program Trends in

Breastfeeding, FY2006-2015

Everbreastfed 3 months 6 months 12 months

Source: ISDH WIC Division

0.0

20.0

40.0

60.0

80.0

100.0

2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Figure 2. Trends in Breastfeeding Initiation by

Race/Ethnicity, FY2006-2015

White Black Hispanic Asian

%


%

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

breastfeeding at 3, 6 and 12 months (49.2%, 41.2% and 30.0% 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).

23.2% 20.5%

36.1%

49.2%

25.1%

15.8% 12.6%

26.2%

41.2%

17.1%

7.8% 4.7%

13.7%

30.0%

8.4%

0.0

10.0

20.0

30.0

40.0

50.0

60.0

White Black Hispanic Asian Total

Figure 3. Percentage of Infants Breastfed For at Least

3, 6 and 12 Months by Race and Ethnicity, FY2015

Breastfed 3 months Breastfed 6 months Breastfed 12 months

%


%

88.1%

79.3%

71.9% 65.5%

58.7%

50.7% 46.1%

39.6% 34.1%

29.8% 26.9%

19.3% 12.9%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0% Figure 4. Prevalence of Breastfeeding Duration Among

Ever Breastfed Infants, FY2015

%

%


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

a concern that baby was not getting enough milk (34.5%) (Figure 5). Other commonly reported

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

breast/prefers bottle” (8.3%) and “Met breastfeeding goal” (7.2%). The reasons that were

combined under “All Other” category included “Anxiety, Lack of Confidence” (1.9%), Infant

Teething/Biting (1.1%), “Mother Pregnant” (0.8%) and “Lack of Support or Encouragement

(0.4%).

34.5%

10.0%

8.3%

7.2%

6.7%

5.1%

4.9%

3.2%

2.9%

2.3%

14.9%

Not Enough Milk, Milk Not Good Enough

Baby Too Demanding, Fussy, Not Satisfied

Infant Refused Breast/Prefers Bottle

Met Breastfeeding Goal

Timeconsuming/Did Not Like It/Tiring

Returned to Work or School

Breast and Nipple problems

Baby Stopped (After 8 Months of Age)

Mother Taking Medication

Medical Reasons, Hospitalization, Disability

All Other / No Answer

Figure 5. Reasons Breastfeeding Ceased, FY2015

Table 1 outlines the prevalence of breastfeeding initiation and breastfeeding duration at 3, 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 74.5% breastfeeding initiation rate and breastfeeding durations

rates of 40.1% at 3 months, 29.0% at 6 months and 18.0% at 12 months.

Married mothers had higher prevalence rates of breastfeeding initiation (78.5% vs.

70.7%), breastfeeding duration at 3 months (36.5% vs. 20.5%), 6 months (27.6% vs.

12.7%) and 12 months (15.0% vs. 5.5%) 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 (71.4%), 6 months (16.2%) and 12 months (7.0%) breastfeeding duration

rates, while those who were obese prior to pregnancy had the lowest 3 months (26.5%)

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 (70.7% vs. 76.0%), 3 months (22.9% vs. 31.4%), 6 months (13.3% vs. 20.1%)

and 12 months (5.9% vs. 10.2%) duration rates compared to those who did not have

anemia.

Women who were enrolled in WIC in either 1st or 2nd trimester of pregnancy had higher

breastfeeding initiation and duration rates compared to those who were enrolled in the 3rd

trimester of pregnancy.

Table 1. Prevalence of Breastfeeding Initiation and Duration to 3, 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 62.0% 12.1% 5.6% 0.0%

15-19 years 72.5% 14.7% 8.9% 4.0%

20-29 years 73.9% 24.2% 16.2% 7.5%

30-39 years 74.9% 34.8% 25.8% 14.3%

39+ years 74.5% 40.1% 29.0% 18.0%

Maternal Marital Status

Single 70.7% 20.5% 12.7% 5.5%

Married 78.5% 36.5% 27.6% 15.0%

Maternal Education

<9 years 75.1% 35.0% 26.8% 15.9%

9-12 years 69.6% 20.2% 13.0% 6.1%

13-15 years 79.6% 31.6% 21.6% 9.7%

16-17 years 87.6% 48.9% 39.5% 22.9%

18+ years 85.2% 48.4% 42.6% 23.9%

Maternal Pre-pregnancy BMI

Underweight 71.4% 27.0% 16.2% 7.0%

Normal Weight 77.9% 29.7% 19.1% 10.1%

Overweight 77.0% 30.4% 19.0% 10.3%

Obese 74.3% 26.5% 16.4% 7.7%

Smoking During Pregnancy

No 77.9% 32.4% 20.7% 10.5%

Yes 61.2% 14.5% 7.1% 2.6%

Household Smoking During

Pregnancy

No 76.4% 31.5% 19.9% 10.0%

Yes 65.7% 17.5% 9.8% 4.6%

Anemia During Pregnancy

No 76.0% 31.4% 20.1% 10.2%

Yes 70.7% 22.9% 13.3% 5.9%

Trimester at Enrollment

1st Trimester 76.4% 29.4% 18.9% 4.9%

2nd Trimester 73.1% 28.8% 18.1% 4.5%

3rd Trimester 72.2% 26.2% 15.6% 3.8%

(1) Reporting period is October 1, 2014 through September 30, 2015. 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. Three local agencies,

Marshall County WIC Program, Whitley County WIC Program and Elkhart County WIC

Program have exceeded the Healthy People 2020 objective to increase the proportion of ever

breastfed infants to 81.9%.

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

Marshall County WIC Program 47 84.5%

Whitley County WIC Program 53 83.5%

Elkhart County WIC Program 08 82.7%

Steuben County WIC Program 50 80.9%

Henry County WIC Program 11 80.7%

Highest Prevalence of Breastfeeding to 3 Months

Kosciusko County WIC Program 59 33.3%

Monroe County WIC Program 25 32.6%



Tippecanoe County WIC Program 41 30.3%



Kosciusko County WIC Program 59 24.4%


Whitley County WIC Program 53 22.6%

Marshall County WIC Program 47 22.3%



Tippecanoe County WIC Program 41 12.0%


Johnson County WIC Program 44 10.7%


(1) Reporting period is October 1, 2014 through September 30, 2015. 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, FY2015

Allen71.2

Lake71.9

Knox54.8

Vigo68.4

White75.8

Jay77.0

Jasper73.8

Cass70.7

Clay71.6

Pike73.3

Rush68.9

Parke66.0

Grant65.9

Greene68.3

Perry61.2

Clark77.4

Ripley68.0

Noble77.0

La Porte54.5

Gibson69.2

Porter82.8

Wells84.1

Posey70.9

Elkhart82.7

Owen73.7

Henry80.7

Boone64.9

Miami69.3

Jackson65.2

Putnam73.2

Dubois78.7

Shelby70.3

Pulaski66.3

Fulton55.4

Marion71.3

Wayne71.1

Clinton78.8

Sullivan77.2

Harrison79.6

Benton68.8

Carroll81.7

Daviess71.1

Martin77.8

Orange79.5

Kosciusko76.6

Monroe83.2

Morgan68.7

Madison70.6

Marshall84.5

Newton68.3

Warrick66.7

Wabash69.3

Warren77.3

Brown74.5

Franklin73.6

Adams87.6

Starke80.3

Spencer67.0

Decatur71.1

Randolph72.5

Lawrence73.3

St Joseph80.1

Whitley83.5

De Kalb71.7

Fountain74.8 Hamilton

82.3

Washington74.3

Tippecanoe79.9

Tipton61.5

Jennings67.9

Delaware69.2

Hendricks80.3

Lagrange80.5

Montgomery76.7

Jefferson68.3

Steuben80.9

Howard60.2

Johnson76.9

Scott60.7

Huntington77.9

Hancock79.8

Crawford76.2

Dearborn64.3

Bartholomew69.6

Fayette69.6

Union68.8

Floyd70.4

Blackford72.6

Verm.76.2

Switzerland66.7

Ohio41.7

Vander-burgh

66.8

41.7 - 61.5

61.6 - 72.9

73.0 - 81.8

81.9 - 87.6

State Percent=72.9%(Healthy People 2020 Objective=81.9%)

Figure 7. Indiana WIC Prevalence of Breastfeeding at 3 Months by County, FY2015

Allen26.6

Lake20.8

Knox15.3

Vigo19.1

White28.1

Jay29.1

Jasper22.5

Cass25.2

Clay20.1

Pike15.6

Rush17.0

Parke18.5

Grant16.4

Greene19.8

Perry15.0

Clark28.5

Ripley23.2

Noble27.6

La Porte19.0

Gibson16.9

Porter26.6

Wells22.0

Posey16.1

Elkhart32.6

Owen19.4

Henry31.1

Boone18.4

Miami20.0

Jackson21.1

Putnam20.9

Dubois28.7

Shelby21.9

Pulaski23.1

Fulton26.5

Marion27.4

Wayne21.7

Clinton24.7

Sullivan26.2

Harrison30.2

Benton20.4

Carroll35.2

Daviess21.1

Martin28.6

Orange31.7

Kosciusko33.3

Monroe36.0

Morgan20.6

Madison23.9

Marshall30.2

Newton20.0

Warrick16.2

Wabash21.9

Warren29.5

Brown32.1

Franklin16.9

Adams27.6

Starke24.2

Spencer15.6

Decatur17.1

Randolph24.7

Lawrence18.2

St Joseph27.0

Whitley29.9

De Kalb27.2


36.0

Washington18.2

Tippecanoe30.3

Tipton24.5

Jennings16.9

Delaware22.2

Hendricks27.1

Lagrange25.5

Montgomery23.3

Jefferson19.9

Steuben27.8

Howard16.5

Johnson28.0

Scott20.6

Huntington23.3

Hancock28.4

Crawford16.7

Dearborn14.9

Bartholomew26.8

Fayette18.7

Union17.0

Floyd20.6

Blackford23.1

Verm.19.1

Switzerland22.2

Ohio0.0

Vander-burgh

17.3

0.0 - 17.3

17.4 - 25.1

25.2 - 29.5

29.6 - 36.0

State Percent=25.1%


Allen16.9

Lake13.7

Knox8.5

Vigo13.2

White20.3

Jay17.6

Jasper15.7

Cass14.9

Clay13.9

Pike12.2

Rush15.2

Parke14.1

Grant10.2

Greene14.1

Perry7.9

Clark19.4

Ripley16.2

Noble20.4

La Porte15.3

Gibson11.5

Porter19.6

Wells16.8

Posey11.1

Elkhart22.7

Owen10.1

Henry19.9

Boone15.0

Miami13.8

Jackson13.9

Putnam14.2

Dubois20.3

Shelby15.7

Pulaski23.1

Fulton13.5

Marion18.8

Wayne13.4

Clinton15.5

Sullivan19.7

Harrison20.9

Benton20.0

Carroll16.1

Daviess13.9

Martin15.2

Orange20.3

Kosciusko24.4

Monroe27.9

Morgan12.6

Madison15.5

Marshall22.3

Newton12.7

Warrick11.9

Wabash14.6

Warren26.3

Brown27.8

Franklin7.7

Adams15.2

Starke16.7

Spencer12.2

Decatur16.2

Randolph17.4

Lawrence11.1

St Joseph18.5

Whitley22.6

De Kalb18.5


24.1

Washington12.8

Tippecanoe21.9

Tipton14.0

Jennings8.9

Delaware15.9

Hendricks16.6

Lagrange15.8

Montgomery16.9

Jefferson12.5

Steuben19.6

Howard10.8

Johnson19.8

Scott13.0

Huntington16.8

Hancock17.5

Crawford11.3

Dearborn12.4

Bartholomew17.9

Fayette13.0

Union14.3

Floyd12.8

Blackford16.8

Verm.13.3

Switzerland7.5

Ohio0.0

Vander-burgh

11.6

0.0 - 8.9

9.0 - 14.3

14.4 - 17.1

17.2 - 27.9



Allen8.7

Jay6.4

Lake6.1

Knox5.6

Vigo6.1

White9.5

Jasper11.5

Cass5.7

Clay6.6

Pike18.2

Rush8.8

Parke7.0

Grant5.9

Greene9.8

Perry2.5

Clark8.6

Ripley8.7

Noble7.8

La Porte6.5

Gibson5.8

Porter10.0

Wells8.9

Posey4.5

Elkhart11.8

Owen6.0

Henry10.5

Boone9.5

Miami6.3

Jackson5.7

Putnam7.0

Dubois10.0

Shelby7.2

Pulaski6.4

Fulton4.9

Marion9.6

Wayne3.8

Clinton5.1

Sullivan10.4

Harrison11.0

Benton10.8

Carroll7.4

Daviess5.8

Martin6.1

Orange10.6

Kosciusko10.0

Monroe16.6

Morgan4.2

Madison7.4

Marshall9.6

Newton1.8

Warrick7.4

Wabash7.8

Warren16.7

Brown28.6

Franklin5.6

Adams7.5

Starke7.0

Spencer1.2

Decatur8.1

Randolph6.5

Lawrence5.6

St Joseph8.8

Whitley9.2

De Kalb8.5


10.9

Washington7.1

Tippecanoe12.0

Tipton8.6

Jennings7.1

Delaware7.2

Hendricks8.4

Lagrange8.4

Montgomery7.5

Jefferson7.7

Steuben7.3

Howard6.1

Johnson10.7

Scott6.1

Huntington10.6

Hancock6.8

Crawford5.5

Dearborn6.2

Bartholomew9.3

Fayette4.7

Union6.5

Floyd6.2

Blackford10.2

Verm.14.4

Switzerland4.2

Ohio0.0

Vander-burgh

5.0

0.0 - 4.5

4.6 - 8.4

8.5 - 14.4

14.5 - 28.6


Documents

15 Breastfeeding report cover