Breastfeeding and Early Combination Feeding ‘los dos ’ in Latinas

Despite what is known about the benefits of breastfeeding to both the infant and mother, racial and ethnic discrepancies exist regarding decisions about breastfeeding, hospital initiation, and duration. According to national data from Pediatric Nutritional Surveillance Survey, Latina women have breastfeeding initiation rates of 73%, but only 30 % are breastfeeding at 6 months, which is well below the Healthy People 2010 goals of 50 % at 6 months. Mothers with lower socioeconomics status and those enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) have even lower initiation rates of 53 % initiation and 21 % duration at 6 months of age. We and others who work with this population had noticed that many of the Latina mothers in Denver initiate breastfeeding with ‘los dos ’ (combination of breast- and bottle-feeding in the newborn nursery). Frequent bottle feedings of formula (topping off after each feeds and other variations on supplementation) in the first week of life often result in lowering of mother’s milk supply. As a result, babies refuse to latch onto the breast and by 2 weeks of age mothers fear of “no tengo leche ” (‘I don’t have milk’) becomes a reality. We recently published a qualitative study in Breastfeeding Medicin