BACKGROUND In addition to its health and nutritional benefits, breastfeeding can save low-income, food insecure mothers the cost of infant formula so that money can be spent on food and other necessities. Yet breastfeeding may exacerbate food insecurity by negatively affecting maternal employment. The relationship between food insecurity and breastfeeding has been explored previously, with varying results. The purpose of this study was to determine the relationship between prenatal food insecurity and breastfeeding initiation and early cessation (< 10 weeks) among U.S. mothers. METHODS Data were pooled from 2012 to 2013 (Phase 7) of the Pregnancy Risk Assessment Monitoring System, a population-based cross-sectional survey of postpartum women administered 2-4 months after delivery. The analytic sample was drawn from Colorado, Maine, New Mexico, Oregon, Pennsylvania, and Vermont, and limited to mothers aged 20 years and older whose infants were alive and living with them at the time of the survey (n = 10,159). We used binomial and multinomial logistic models to assess the predictive association between food insecurity and breastfeeding initiation and early cessation, respectively, while controlling for confounders. RESULTS Most women reported prenatal food security (90.5%) and breastfeeding initiation (91.0%). Of those who initiated breastfeeding, 72.7% breastfed for > 10 weeks. A larger proportion of food secure women compared to food insecure women, initiated breastfeeding (91.4% vs. 87.6%, P < 0.01), and patterns of early breastfeeding cessation differed significantly between the two groups (P < 0.01). In the final models, prenatal food insecurity was not associated with breastfeeding initiation or early cessation, with one exception. Compared to food secure mothers, mothers reporting food insecurity had a lower risk of breastfeeding for 4-6 weeks than for > 10 weeks, independent of covariates (relative risk ratio 0.65; 95% CI 0.50, 0.85; P < 0.01). Women who were married, had a college degree, and did not smoke were more likely to initiate breastfeeding and breastfeed for a longer time, regardless of food security status (P < 0.01). CONCLUSIONS Socioeconomic, psychosocial, and physiological factors explain the association between prenatal food insecurity and breastfeeding outcomes among this U.S. SAMPLE More targeted and effective interventions and policies are needed to encourage the initiation and duration of breastfeeding, regardless of food security status.

中文翻译：

---

产前食品不安全对母乳喂养行为的作用：美国妊娠风险评估监测系统的发现。

背景技术除了健康和营养益处外，母乳喂养还可以为低收入、粮食不安全的母亲节省婴儿配方奶粉的费用，以便将钱花在食品和其他必需品上。然而，母乳喂养可能会对孕产妇就业产生负面影响，从而加剧粮食不安全。之前已经探讨过粮食不安全和母乳喂养之间的关系，但结果各不相同。本研究的目的是确定美国母亲产前食品不安全与母乳喂养开始和提前停止（< 10 周）之间的关系。方法 汇总了 2012 年至 2013 年（第 7 阶段）妊娠风险评估监测系统的数据，该系统是一项针对产后 2-4 个月进行的基于人群的横断面调查。分析样本来自科罗拉多州、缅因州、新墨西哥州、俄勒冈州、宾夕法尼亚州和佛蒙特州，仅限于调查时婴儿还活着并与她们住在一起的 20 岁及以上的母亲 (n = 10,159)。我们使用二项式和多项式逻辑模型分别评估食品不安全与母乳喂养开始和提前停止之间的预测关联，同时控制混杂因素。结果 大多数妇女表示产前粮食安全（90.5%）和开始母乳喂养（91.0%）。在开始母乳喂养的人中，72.7% 的母乳喂养时间超过 10 周。与食品不安全的女性相比，食品安全的女性开始母乳喂养的比例更高（91.4% vs. 87.6%，P < 0.01），并且两组之间早期停止母乳喂养的模式存在显着差异（P < 0.01）。在最终模型中，产前食物不安全与母乳喂养的开始或提前停止无关，但有一个例外。与食品安全的母亲相比，报告食品不安全的母亲在 4-6 周内的母乳喂养风险低于超过 10 周的母乳喂养风险，与协变量无关（相对风险比 0.65；95% CI 0.50, 0.85；P < 0.01）。无论粮食安全状况如何，已婚、拥有大学学位且不吸烟的女性更有可能开始母乳喂养且母乳喂养时间更长（P < 0.01）。结论 社会经济、社会心理和生理因素解释了美国样本中产前食品不安全与母乳喂养结果之间的关联。无论食品安全状况如何，都需要更有针对性和有效的干预措施和政策来鼓励母乳喂养的开始和持续时间。