Concerns related to breastfeeding and lactation support are routinely addressed during postpartum visits. However, some recent studies show that approximately 40% of postpartum patients never return for comprehensive postpartum care. Therefore, in this study we examined the associations between postpartum healthcare utilization and breastfeeding practices, using representative sample data from 4,843 women who participated in the 2016 to 2020 Virginia Pregnancy Risk Assessment Monitoring System (VA-PRAMS). The survey collected a wide range of information to include women’s socioeconomic background, attendance of a postpartum healthcare visit, and breastfeeding practices. Multivariate logistic regression was employed for the examination of not attending a postpartum checkup and no breastfeeding initiation. Models were adjusted for potential confounders such as sociodemographics and unplanned pregnancy. Over 11% of women had no postpartum healthcare visit and 25.93% never initiated breastfeeding after their recent delivery. The rates of never initiating breastfeeding were highest among women who were African American (25.34%), Medicaid participants (24.97%) and had low household income (20.10%), p < 0.001. Overall, women without a postpartum checkup demonstrated significantly increased odds of not initiating breastfeeding (AOR: 2.11, CI:1.39 - 3.21, p < 0.001), and attained a high school or less education (AOR: 4.28, CI: 2.70 - 6.78, p < 0.001).  Findings highlighted that targeted intervention to improve postpartum visits will bring added value to improve the breastfeeding practices among Virginia mothers to optimize the benefits of breastfeeding for improved maternal and child health outcomes. 

Samantha Brown has recently completed her Master of Public Health in Epidemiology from Eastern Virginia Medical School in May 2024. During her study at EVMS, she worked as a Teaching Assistant in the Principles of Epidemiology course. She is passionate about maternal and child health research (MCH). She pursed her practicum project at EVMS Pediatrics Department and led a secondary analysis of the VA-PRAMS to examine the patterns of health utilization, and its effect on health outcomes of mothers and infants. This study is completed as a component of her practicum project to fulfill her MPH degree at EVMS.