Background. We studied the effect of functional health literacy on the initiation and continuance of breast-feeding in women at a public health clinic. Methods. Subjects were 61 first-time mothers aged 18 years or older who spoke English as their first language. They were divided into two groups, one who exclusively breast-fed for at least the first 2 months and one who never initiated breast-feeding or did not exclusively breast-feed for at least 2 months. The Rapid Estimate of Adult Literacy in Medicine (REALM) was administered, providing reading grade-level estimates for each subject. Results. An association between functional health literacy and breast-feeding was seen, with only 23% of the women in the lower literacy group exclusively breast-feeding during the first 2 months compared with 54% of women in the higher literacy group. Conclusion. Many patients need simpler health education materials encouraging breast-feeding. These materials are needed both before and during pregnancy.
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