Breastfeeding initiation and duration among low-income women in Alabama: the importance of personal and familial experiences in making infant-feeding choices.

To gain perspective on breastfeeding initiation and duration among poor women in the southeastern United States, the authors interviewed a random sample of 150 mothers (93% African American) at a county health clinic in Birmingham, Alabama. Forty-one percent of women initiated breastfeeding, 24% breastfed for at least 1 month, and 8.3% breastfed for 3 months or more. Initiation of breastfeeding was positively associated with the mother having been breastfed herself and having breastfed a previous infant, and negatively associated with premature delivery. Breastfeeding at 1 month was more likely among older women and women with close relatives who breastfed. Duration of breastfeeding beyond 1 month was associated only with the mother having been breastfed and having breastfed a previous infant. Maternal and familial breastfeeding experiences eliminated the effect of more distal factors, such as income or education, on some feeding decisions. The strong influence of breastfeeding experiences must be considered in infant feeding interventions.