1. PRAMS data by Racial/ethnic identity
Effective Practices
PRAMS data by Racial/ethnic identity
Rachel A. Sebastian, MA
Medical Sociologist
Child Policy Research Consulting, LLC

2. Maternity Care Practices
PRAMS Questions about Maternity Care Practices
Hospital staff gave me information about breastfeeding.
My baby stayed in the same room with me at the hospital.
I breastfed my baby at the hospital.
I breastfed in the first hour after my baby was born.
Hospital staff helped me learn how to breastfeed.
My baby was fed only breast milk at the hospital.
Hospital staff told me to breastfeed whenever my baby wanted.
The hospital gave me a breast pump to use.
The hospital gave me a gift pack with formula.
The hospital gave me a telephone number to call for help with breastfeeding.
My baby used a pacifier at the hospital.

3. Characteristics of Respondents, PRAMS 2012-2013
Maternal Race/Ethnicity/Acculturation
English-Speaking Hispanic
40.4%
Spanish-Speaking Hispanic
7.7%
Non-Hispanic Native American
14.1%
Non-Hispanic White
27.3%
Collected
Total of 4,035 women
Maternal Age
< 20 years
12.1%
20 – 29 years
56.7%
30+ years
31.3%
Maternal Education
Less than HS Diploma or GED
19.1%
HS Diploma or GED
26.8%
Any Post-Secondary Education
54.1%

4. % Breastfed at least 2 months
Breastfeeding Duration by Race, Ethnicity, & Acculturation, PRAMS
Percent of Women who Breastfed for at Least 2 Months, Phase 7 Only
% Breastfed at least 2 months 1 2
Sig.
Race/Ethnicity
White, non-Hispanic1 vs Non-White2
73.2%
60.8%
0.000
Hispanic1 vs Non-Hispanic2
59.4%
68.7%
Native American1 vs Non-Native American2
64.7%
64.1%
0.254
Language
English1 vs Spanish2
70.3%
63.6%
Acculturation
English-Speaking Hispanic1 vs Spanish-Speaking Hispanic2
57.4%
70.0%

5. Maternity Care Practices Associated with an Increased Likelihood of Breastfeeding for At Least Two Months
English-Speaking Hispanic Women
1. Breastfed at the hospital.
2. Baby only had breast milk at hospital.
3. Staff encouraged on-demand breastfeeding.
Spanish-Speaking Hispanic Women
1. Staff encouraged on-demand breastfeeding.
2. Baby only had breast milk at the hospital.
3. Hospital provided information on breastfeeding.
Non-Hispanic Native American Women
1. Staff encouraged on-demand breastfeeding.
2. Breastfed at the hospital.
3. Hospital provided phone number for breastfeeding support.
Non-Hispanic White Women
1. Breastfed at the hospital.
2. Baby only had breast milk at hospital.
3. Breastfed within the first hour of birth.

6. Data  Practice Some maternity care practices are universally helpful:
Breastfeeding at the hospital;
Feeding only breast milk at the hospital;
Staff encouraging on-demand breastfeeding.
We need a better understanding of how maternity care practices are impacting all populations of patients:
Is the hospital providing information that is culturally sensitive, appropriate, and relevant?
How do hospital practices interact with cultural practices associated with breastfeeding? Are they consistent or conflicting?
Are there linkages between all populations of women and existing resources?
We need qualitative data to better understand women’s experiences in the hospital and how these experiences influence breastfeeding duration and exclusivity.
What does this mean for improving maternity care practices in hospitals and reducing breastfeeding disparities?

8. Effect of Maternity Care Practices on Likelihood of Breastfeeding for at Least Two Months by Race, Ethnicity, & Acculturation
Non-Hispanic White
Non-Hispanic Native American
Spanish-Speaking Hispanic
English-Speaking Hispanic
Breastfed at hospital
(1)
(2)
Breastfed w/in first hour
(3)
Only breast milk
Same room
Used a pacifier at the hospital
Gave gift pack with formula
Provided pump
Provided information
Helped learn
On demand
Phone number

9. Effect of Maternity Care Practices on Likelihood of Breastfeeding for at Least Two Months by Race, Ethnicity, & Acculturation
Non-Hispanic White
Non-Hispanic Native American
Spanish-Speaking Hispanic
English-Speaking Hispanic
Breastfed at hospital
2.304
0.000
2.166
1.804
0.003
2.030
Breastfed w/in first hour
1.806
0.445
0.564
1.049
0.244
Only breast milk
1.855
1.443
4.834
1.548
Same room
1.211
0.063
1.054
0.708
1.574
0.148
0.814
Used a pacifier at the hospital
0.601
1.723
0.717
0.002
0.674
Gave gift pack with formula
0.555
0.417
1.391
0.800
Provided pump
1.553
0.904
0.084
0.848
Provided information
0.625
0.821
0.254
2.543
0.684
Helped learn
0.759
0.499
0.259
0.599
On demand encouraged
1.173
0.016
2.180
6.508
1.446
Phone number
1.453
1.842
0.641
1.430