Introduction
Social support is a modifiable social determinant of health that shapes breastfeeding
outcomes and may contribute to racial and ethnic breastfeeding disparities. This study
characterizes the relationship between social support and early breastfeeding.
Methods
This is a cross-sectional analysis of baseline data collected in 2019–2021 for an
RCT. Social support was measured using the Enhancing Recovery in Coronary Heart Disease
Social Support Instrument. Outcomes, collected by self-report, included (1) early
breastfeeding within the first 21 days of life, (2) planned breastfeeding duration,
and (3) confidence in meeting breastfeeding goals. Each outcome was modeled using
proportional odds regression, adjusting for covariates. Analysis was conducted in
2021–2022.
Results
Self-reported race and ethnicity among 883 mothers were 50% Hispanic, 17% Black, 23%
White, and 10% other. A large proportion (88%) of mothers were breastfeeding. Most
breastfeeding mothers (82%) planned to breastfeed for at least 6 months, with more
than half (58%) planning to continue for 12 months or more. Most women (65%) were
confident or very confident in meeting their breastfeeding duration goal. In adjusted
models, perceived social support was associated with planned breastfeeding duration
(p=0.042) but not with early breastfeeding (p=0.873) or confidence in meeting breastfeeding goals (p=0.427). Among the covariates, maternal depressive symptoms were associated with lower
breastfeeding confidence (p<0.001).
Conclusions
The associations between perceived social support and breastfeeding outcomes are nuanced.
In this sample of racially and ethnically diverse mothers, social support was associated
with longer planned breastfeeding duration but not with early breastfeeding or breastfeeding
confidence.
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Publication history
Published online: November 29, 2022
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© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
