Association of Voluntary Legal Paternity and Breastfeeding Duration and Exclusivity in a Sample of Mothers in NewYork State, United States

Abstract

Background and Objective: Globally, father engagement is deemed an important factor in mothers’ breastfeeding practices. In the U.S., the role of the father in breastfeeding is understudied. This study examines the association between voluntary legal paternity and maternal breastfeeding outcomes. Methods: Using data from a modified Pregnancy Risk Assessment Monitoring System survey (Monroe County, NY, 2015-2017) linked to New York State’s birth certificate data, we assessed breastfeeding outcomes (exclusivity and duration) by voluntary legal paternity (VLP) establishment. We examined breastfeeding duration (breastfeeding cessation at 13 weeks or less) and exclusive breastfeeding (at 13 weeks) among mothers whose infants had VLP (i.e., married, acknowledgment at birth), and those who had no-VLP (i.e., a court-mandated Paternity Affidavit or no legal paternity established). Univariate analyses were conducted, with additional variables (parental demographics, maternal social and clinical) included subsequently. The backward elimination method was used to determine the set of covariates to adjust in the model. Results: Of the 1,753 mothers initiating breastfeeding, 1,364 had VLP and 389 had no-VLP established. Mothers of infants with a no-VLP were more likely to be Black (29.49%), Hispanic (17.74%), have lower income (80.21%), have lower-education levels (44.73%) and were more likely to be further indication of the need for additional breastfeeding support, especially among socio-economically disadvantaged populations.