277 - The Effect of Prenatally Perceived Chronic Racial and Ethnic Discrimination on Infant Feeding Behaviors and Breastfeeding Practice through 6 months

Poster Number: 277
Publication Number: 277.1489

Background: Racism and discrimination are two key social determinants of health, yet less is known about how they may affect disparities in infant feeding practices. Investigating the relationship between prenatally perceived discrimination, infant feeding behavior and breastfeeding practice is crucial to promote equity in the prevalence optimal infant nutrition.

Objective: This study’s aim was to determine the association between prenatally perceived chronic racial/ethnic discrimination, infant feeding behaviors and breastfeeding practice at 2, 4 and 6 months.

Design/Methods: A cross-sectional analysis was conducted with secondary data from mother-baby dyads who were enrolled into the COVID-19 Mother-Baby Outcomes [COMBO] Study. The main predictor of prenatally perceived discrimination was measured using the maternal-reported, validated 22-item Race-Related Events Scale [RES] whereby higher scores (range 0-22) indicate greater exposure to race-related stress (Cronbach α=.78-.88). The main outcomes of infant feeding behaviors and practices were measured with the maternal-reported, validated 18-item Baby Eating Behavior Questionnaire [BEBQ]-Appetite subscale (range 0-5) and exclusive breastfeeding frequencies from 2-6 months. Multivariable linear and logistic regression models adjusted for covariates such as race, ethnicity, parity, gestation, maternal age, and insurance type were statistically significantly associated with outcomes.

Results: Of the N=463 dyads from New York, Utah, and Alabama, 29.3% self-identified as Black/Hispanic, 65% as White, 5.76% as Other Race. Black/Hispanic mothers reported significantly higher mean RES scores compared to White (3.1±4.5 vs. 0.6±1.9, p< 0.0001) but not Other Race mothers (2.5+2.8, p=0.6). RES score was significantly positively associated with BEBQ-AP scores (β=0.059, 95% [Confidence Interval] 0.882,1.057, p=0.01) on adjusted analysis. The odds of exclusive breastfeeding for mothers with higher RES score was 0.96 times the odds of mothers with lower RES scores, but this relationship was not significant after controlling for covariates ([Adjusted Odds Ratio] 0.97, 95% [CI] 0.9-1.1).

Conclusion(s): Prenatal chronic exposure to racial and ethnic discrimination was significantly associated with maternal perceptions of infant appetite, but not to exclusive breastfeeding practices. Infant appetitive traits may be associated with future weight gain. Further research on perceived discrimination as a social determinant of maternal and infant health in a larger sample may inform public health efforts to improve optimal infant nutrition.