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. 2021 May 28;70(21):769–774. doi: 10.15585/mmwr.mm7021a1

TABLE. Percentage of live infants not transferred to another facility for whom breastfeeding was initiated,* by state/territory and maternal race/ethnicity — National Vital Statistics System, 48 states,§ District of Columbia, Guam, Northern Mariana Islands, and Puerto Rico, 2019.

Jurisdiction No. of infants (% initiating breastfeeding)
Largest disparity**
Overall Hispanic White Black Asian AI/AN NH/OPI Multiracial
United States††
3,129,646 (84.1)
665,584 (87.4)
1,686,505 (85.5)
492,852 (73.6)§§
164,602 (90.3)¶¶
25,807 (76.6)
7,843 (80.2)
69,626 (83.1)
16.7
Alabama
56,054 (69.6)
4,730 (64.2)
32,031 (77.2)
17,285 (56.1)§§
863 (84.6)¶¶
140 (73.6)
—***
971 (71.5)
28.5
Alaska
9,492 (92.9)
761 (95.9)
4,685 (96.3)¶¶
288 (94.4)
569 (81.0)
1,812 (88.5)
293 (76.1)§§
919 (94.7)
20.2
Arizona
78,613 (88.9)
33,426 (87.9)
31,629 (91.1)
4,489 (84.5)
2,846 (93.3)¶¶
3,739 (84.7)
218 (80.7)§§
1,842 (86.6)
12.6
Arkansas
34,123 (73.7)
3,769 (81.9)
21,994 (78.0)
6,052 (52.3)§§
698 (85.0)¶¶
218 (72.9)
506 (67.0)
654 (74.3)
32.7
Colorado
62,552 (92.8)
18,032 (90.4)
35,906 (94.6)¶¶
3,009 (88.4)
2,552 (93.3)
375 (85.1)§§
167 (91.0)
1,532 (92.3)
9.5
Connecticut
34,558 (87.4)
8,861 (85.5)
18,616 (88.4)
4,096 (84.0)§§
2,253 (93.1)¶¶


687 (84.6)
9.1
Delaware
10,717 (80.5)
1,723 (83.8)
5,332 (82.2)
2,687 (72.7)
608 (93.8)¶¶


329 (72.6)§§
21.2
DC
13,092 (84.2)
1,846 (82.5)
4,799 (97.1)¶¶
5,313 (71.2)§§
808 (95.5)


300 (88.7)
25.9
Florida
215,942 (87.2)
67,193 (91.1)
91,783 (87.7)
46,750 (79.6)§§
6,944 (92.9)¶¶
224 (81.7)
161 (88.8)
2,839 (86.6)
13.3
Georgia
124,711 (83.1)
18,259 (90.1)
53,889 (84.5)
43,241 (77.0)§§
5,777 (93.9)¶¶
93 (83.9)
99 (81.8)
2,472 (84.6)
16.9
Hawaii
16,583 (89.6)
2,567 (92.1)
3,182 (96.8)¶¶
422 (96.2)
4,287 (86.3)

1,671 (78.2)§§
4,387 (90.3)
18.6
Idaho
21,463 (92.2)
3,653 (90.1)
16,448 (92.8)
258 (94.6)
347 (93.7)
224 (78.6)§§
74 (97.3)¶¶
401 (91.8)
18.7
Illinois
134,795 (83.1)
29,555 (86.4)
70,731 (85.2)
22,406 (67.7)§§
9,091 (93.1)¶¶
74 (81.1)

1,904 (81.5)
25.4
Indiana
80,077 (82.9)
8,316 (85.4)¶¶
57,777 (84.1)
10,077 (74.1)§§
2,250 (84.0)
58 (75.9)
59 (79.7)
1,516 (81.1)
11.3
Iowa
36,876 (83.1)
3,821 (81.0)
28,030 (84.9)
2,861 (69.6)§§
1,102 (85.5)¶¶
259 (73.7)
156 (73.7)
645 (78.3)
15.9
Kansas
36,442 (89.6)
6,290 (87.1)
25,216 (90.9)
2,626 (84.3)
1,250 (93.4)¶¶
131 (84.7)
66 (77.3)§§
797 (85.3)
16.1
Kentucky
49,321 (71.7)
3,216 (82.1)
39,288 (71.1)
4,650 (67.0)§§
1,007 (86.8)¶¶

58 (79.3)
924 (69.9)
19.8
Louisiana
56,966 (71.0)
4,851 (82.2)
28,945 (78.9)
21,027 (56.5)§§
1,136 (87.0)¶¶
239 (70.7)

705 (74.3)
30.5
Maine
11,148 (89.4)
237 (85.2)
9,844 (89.4)
514 (92.0)
211 (93.4)¶¶
87 (83.9)§§

249 (83.9)§§
9.5
Maryland
66,056 (87.1)
12,166 (94.1)
27,898 (86.4)
19,537 (82.0)§§
4,547 (95.4)¶¶
67 (83.6)

1,582 (84.5)
13.4
Massachusetts
68,897 (88.4)
14,027 (86.9)
39,346 (88.3)
6,776 (90.5)
6,197 (91.4)¶¶
78 (84.6)§§

1,491 (85.5)
6.8
Minnesota
62,276 (89.7)
4,867 (90.2)
42,110 (91.9)¶¶
7,690 (87.5)
5,032 (78.9)
858 (67.5)§§
52 (86.5)
1,545 (85.8)
24.4
Mississippi
35,022 (64.7)
1,620 (71.7)
17,195 (74.5)
15,270 (52.5)
437 (83.3)¶¶
219 (49.3)§§

255 (70.6)
34.0
Missouri
69,799 (79.7)
4,228 (81.0)
50,967 (82.2)
10,019 (65.5)§§
1,731 (88.9)¶¶
150 (72.0)
219 (74.0)
2,224 (78.6)
23.4
Montana
10,929 (90.6)
611 (90.0)
8,737 (93.1)¶¶
61 (86.9)
116 (89.7)
1,050 (70.2)§§

324 (88.6)
22.9
Nebraska
24,724 (88.6)
4,145 (85.5)
17,316 (90.5)
1,570 (78.6)
835 (91.1)¶¶
218 (74.3)§§

617 (84.1)
16.8
Nevada
33,410 (80.0)
12,610 (81.9)
11,895 (84.2)¶¶
4,263 (64.1)§§
2,542 (81.2)
241 (83.4)
363 (72.2)
1,386 (77.4)
20.1
New Hampshire
11,609 (90.8)
728 (90.1)
9,979 (90.6)
253 (94.9)
454 (96.5)¶¶


129 (85.3)§§
11.2
New Jersey
95,969 (79.7)
26,746 (80.9)
43,923 (81.0)
12,877 (70.9)§§
10,317 (83.2)¶¶
64 (73.4)

1,075 (78.4)
12.3
New Mexico
21,040 (86.1)
11,503 (84.8)
5,728 (88.9)
332 (81.6)§§
374 (91.2)¶¶
2,688 (86.1)

370 (84.9)
9.6
New York
219,529 (87.9)
49,898 (90.4)¶¶
107,699 (87.4)
31,926 (84.4)
24,683 (89.8)
358 (82.1)
71 (81.7)§§
3,195 (82.3)
8.7
North Carolina
119,198 (81.6)
19,084 (88.1)
62,586 (84.6)
27,785 (70.8)
4,957 (89.0)¶¶
1,429 (52.1)§§
127 (82.7)
3,130 (79.4)
36.9
North Dakota
11,702 (85.0)
733 (83.8)
8,499 (88.2)
756 (86.0)
251 (91.6)¶¶
847 (54.0)§§

358 (81.3)
37.6
Ohio
128,555 (76.0)
7,428 (77.8)
91,498 (77.2)
21,415 (68.8)§§
4,237 (87.1)¶¶
98 (78.6)
101 (72.3)
3,600 (70.9)
18.3
Oklahoma
46,523 (81.8)
7,284 (81.8)
25,823 (84.7)
3,961 (71.6)
1,215 (85.8)¶¶
4,485 (74.8)
218 (62.4)§§
3,478 (80.2)
23.4
Oregon
41,473 (94.8)
8,019 (94.7)
27,456 (94.9)
1,006 (94.9)
2,374 (97.1)¶¶
398 (88.4)§§
336 (91.1)
1,599 (93.7)
8.7
Pennsylvania
128,439 (82.2)
16,017 (81.8)
84,758 (83.0)
16,922 (76.9)§§
6,002 (91.1)¶¶
77 (79.2)

3,073 (77.7)
14.2
Rhode Island
10,592 (67.7)
2,919 (56.3)
5,959 (75.2)
828 (54.5)§§
528 (76.1)¶¶


272 (56.6)
21.6
South Carolina
52,493 (78.1)
5,414 (86.5)
28,919 (82.8)
15,609 (66.0)§§
1,001 (90.6)¶¶
100 (68.0)
53 (73.6)
1,275 (77.1)
24.6
South Dakota
11,966 (80.7)
679 (77.5)
8,758 (84.7)¶¶
421 (79.1)
208 (72.6)
1,479 (61.2)§§

398 (76.1)
23.5
Tennessee
84,201 (81.1)
8,596 (85.3)
55,082 (83.0)
16,540 (71.3)§§
1,846 (92.0)¶¶
97 (87.6)
73 (87.7)
1,588 (83.2)
20.7
Texas
376,721 (88.5)
179,268 (88.4)
124,558 (90.4)
47,113 (81.5)§§
19,806 (95.2)¶¶
693 (87.6)
572 (86.5)
4,349 (87.8)
13.7
Utah
47,200 (86.2)
8,194 (81.8)
33,650 (88.8)¶¶
608 (73.4)
1,088 (85.1)
354 (75.7)
447 (69.1)§§
1,073 (88.6)
19.7
Vermont
5,062 (91.3)
124 (93.5)
4,555 (91.0)§§
126 (97.6)¶¶
123 (97.6)¶¶


82 (93.9)
6.6
Virginia
95,415 (86.2)
14,294 (92.1)
51,270 (87.3)
20,448 (76.3)§§
7,351 (94.5)¶¶
142 (88.0)
124 (89.5)
1,706 (87.7)
18.2
Washington
82,930 (94.6)
15,885 (92.8)
46,246 (95.3)
3,689 (94.4)
8,665 (96.7)¶¶
996 (88.8)§§
1,177 (91.0)
3,557 (94.7)
7.9
West Virginia
18,187 (64.8)
359 (77.4)
16,590 (64.6)
591 (59.4)§§
170 (86.5)¶¶


387 (64.6)
27.1
Wisconsin
60,439 (81.1)
6,270 (79.0)
42,876 (86.6)¶¶
6,357 (53.8)§§
2,851 (68.4)
581 (69.2)

1,329 (76.1)
32.8
Wyoming
5,765 (83.9)
762 (77.3)
4,504 (85.6)
52 (65.4)§§
65 (87.7)¶¶
170 (70.6)

106 (83.0)
22.3
NMI
669 (97.3)



252 (97.6)¶¶

377 (97.3)§§

0.3
Guam
2,661 (80.6)

175 (90.9)¶¶

721 (78.5)§§

1,607 (79.9)
86 (84.9)
12.4
Puerto Rico 19,910 (93.6) 19,432 (93.6)¶¶ 401 (92.3)§§ 1.3

Abbreviations: AI/AN = American Indian/Alaska Native; DC = District of Columbia; NH/OPI = Native Hawaiian/Other Pacific Islander; NMI = Northern Mariana Islands.

* Excludes infants transferred to another facility within 24 hours of delivery and those who died before completion of the birth certificate.

All racial/ethnic groups are non-Hispanic unless otherwise noted.

§ Includes all states except California and Michigan.

Denominators might not sum to total because of missing maternal race/ethnicity data.

** Largest disparity is defined as the percentage point difference in breastfeeding initiation prevalence between the racial/ethnic groups with the highest and lowest initiation prevalence.

†† United States estimates include data from 48 states and DC but exclude data from territories.

§§ Racial/ethnic group with the lowest breastfeeding initiation prevalence.

¶¶ Racial/ethnic group with highest breastfeeding initiation prevalence.

*** Data were suppressed for all racial/ethnic groups with denominators <50.