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A national survey on infant feeding practices revealed that Native-American mothers have a lower breast-feeding incidence and duration when compared to Whites . Several socioeconomic risk factors widespread in this population may contribute to this observation. Nearly one-half of Native Americans have an annual household income under the poverty level , only 8% have a college degree , and few Native Americans obtain prenatal care, especially in the first trimester .
The lower incidence of breast-feeding may also reflect cultural changes that have eliminated breast-feeding as a traditional practice . According to a recent study, about one-third of Native Americans in the United States live on a reservation and nearly one-half live in urban areas . Lindenberg  found that urbanization tends to inact changes in lifestyle and cultural norms. When Native Americans move away from reservations, they often leave behind the traditional lifestyle that supported breast-feeding [6,7]. In the past, many pregnant women were prepared for childbirth and lactation by their mothers . Today, Native-American women are often separated from female relatives. When this support is lost, the traditional practice of breast-feeding may shift to formula feeding [9-12].
The decline in breast-feeding among Native-American mothers is a concern to health professionals who advocate its practice . Higher breast-feeding rates among Native Americans can promote health in a population with many socioeconomic health risks [14,15]. Social and cultural factors that influence Native-American mothers' infant feeding decisions need to be understood to effectively respond to the American Academy of Pediatrics position to promote breast-feeding . This study examined breast-feeding rates and attitudes among Native Americans enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children Supplemental Food Program (WIC) in eastern Washington state.
Women were eligible for the study if they were of Native American descent, had a child between 6 months and 5 years of age who, if breast-fed, was weaned, were enrolled in WIG, were aged 18 years or more, and were able to read and write. A pilot-tested, retrospective questionnaire was distributed to S WIG clinics in eastern Washington. The questionnaire assessed demographic characteristics of the sample and factors related to breastfeeding initiation and duration. The survey combined open-ended and forced answer choice items. Eligible mothers were informed about the study at a WIG appointment, and their voluntary participation in the study was sought …