Food deserts reduce breastfeeding initiation

SAN DIEGO — Living within a food desert is an important risk factor for decreased breastfeeding initiation, according to findings presented at the ACOG Annual Clinical and Scientific Meeting.

“Living in a food desert can have an impact on accessing nutritious foods during pregnancy and during the postpartum period, which can influence perinatal health,” Ronee Wilson, PhD, an assistant professor of reproductive and perinatal epidemiology in the College of Public Health at the University of South Florida, told Healio. “Additionally, food deserts are often a proxy for areas experiencing socioeconomic disadvantage. So, there may potentially be other access issues experienced by residents in these areas (eg, maternity deserts, pharmacy deserts, etc.).”

The researchers investigated this association using Florida Department of Health birth data from 2019. They linked these data to the 2019 U.S. Department of Agriculture (USDA) Food Access Research Atlas.

Wilson and colleagues defined a food desert tract using the USDA definition of “low-income census tracts with a substantial number or share of residents with low levels of access to retail outlets selling healthy and affordable foods.”

Out of 209,087 live singleton births, 16% of mothers resided in a food desert, according to the researchers. These individuals had decreased breastfeeding initiation compared with those who did not reside in a food desert (adjusted RR = 1.26).

The researchers found that Black individuals had the highest risk for decreased initiation (aRR = 1.26), whereas Hispanic (aRR = 0.58) and Asian or Pacific Islander individuals (aRR = 0.74) had the lowest risk.

Lower education achievement was associated with decreased breastfeeding initiation (middle school: aRR = 5.42; high school: aRR = 3.46; some college: aRR = 1.95), Wilson and colleagues reported. Education was the social factor most strongly associated with decreased breastfeeding initiation. A history of diabetes (aRR = 1.14) and preterm (aRR = 1.47) or low birth weight (aRR = 1.38) was also associated with reduced initiation, according to the researchers.

“Breastfeeding is associated with improved health outcomes for mothers and infants,” Adetola F. Louis-Jacques, MD, an assistant professor in the department of OB/GYN at the University of Florida and an OB/GYN at the UF Women’s Health Center, told Healio. “Breastfeeding benefits for infants include reduced risk of ear infections, gastroenteritis and lower respiratory tract infections requiring hospitalizations as well as lower risk of childhood obesity. For mothers, breastfeeding is associated with reduced risk of certain types of cancers, hypertension, CVD and type 2 diabetes.”

Understanding how food deserts impact breastfeeding initiation may allow for more tailored interventions like better monitoring and evaluation methods, improved parental leave and Baby Friendly hospital designations, according to Wilson.

“On a community or individual level, normalization of breastfeeding is important in boosting mothers breastfeeding self-efficacy and strengthening their ability to successfully breastfeed their babies,” she said. “Prenatal and postpartum peer counseling interventions led by social workers, family support workers and doulas have also been successful in increasing breastfeeding rates.”

References:

Mapping food deserts in the United States. https://www.ers.usda.gov/amber-waves/2011/december/data-feature-mapping-food-deserts-in-the-us/. Published Dec. 1, 2011. Accessed May 4, 2022.

Smith MA, et al. A199. Presented at: ACOG; May 6-8, 2022; San Diego.