Housing Insecurity, Housing Conditions, and Breastfeeding Behaviors for Medicaid-Eligible Families in Urban Settings.

This was a secondary analysis of data from a parenting randomized trial, not a test of housing support or breastfeeding interventions, so it cannot show that helping families with housing would improve breastfeeding. Housing and feeding data relied on self-report and recall, which may introduce bias. Breastfeeding intention was measured only within 3 weeks after birth, and exclusivity was measured only at 6 months, so changes between those times were not captured. The demographic table reports 360 participants, while the analysis text reports 361 mother-infant dyads. Race/ethnicity was highly conflated with site, because most Pittsburgh participants were Black and most New York City participants were Latina, so the study could not separate race from location. Subgroup analyses were underpowered and did not allow significance testing, so the differences by site and race/ethnicity should be read cautiously. The Smart Beginnings intervention may have collateral effects on breastfeeding, but those effects were not examined in this paper. Housing measures were objective only and did not capture how unstable participants felt or whether they experienced racism in housing.

The authors declared no potential conflicts of interest. Funding came from the Eunice Kennedy Shriver National Institute of Child Health and Human Development under Award Number R01HD076390.

Do not conclude that housing insecurity causes lower breastfeeding, or that housing support will increase breastfeeding. This paper reports associations from existing data and did not test a housing intervention. The crowding finding also changed by site and race/ethnicity, so it is not a general rule.