Background and rationale. Breastfeeding has been shown to have substantial health benefits for both mother and child. Louisiana has one of the lowest rates of breastfeeding in the United States as only 50% of women (63% of White and 30% of African-American women) initiated breastfeeding in 2001 Objectives. The purpose of this study was to determine effects of race, education, race by education interaction, stressful life events and pregnancy intention on breastfeeding initiation Methods. Using data from the 2000-2002 Louisiana Pregnancy Risk Assessment Monitoring System (La PRAMS), the proportion of White and African American women who initiated breastfeeding was ascertained. Using a representative sample of 2609 primiparous, White and African American women, multivariate logistic regression modeling was used to determine the adjusted effects of race, education, race by education interaction, stressful life events and pregnancy intention on breastfeeding initiation among the total sample, and stratified by race Results. Between 2000 and 2002, 53% of new first time mothers initiated breastfeeding (66% of White and 32% of African American women). After controlling for sociodemographic variables, African American women were 63% less likely to initiate breastfeeding as White women (95% CI 0.3, 0.5). There was no significant interaction between race and education. The only stressful life event independently associated with breastfeeding initiation was moving to a new address (OR 1.4, 95% CI 1.1, 1.8). Pregnancy intention was not independently associated with breastfeeding initiation Conclusion. Rates of breastfeeding in Louisiana are lower than the national rates and much lower than the goals set forth in Health People 2010. Race remains a significant predictor of breastfeeding, even after controlling for education and other sociodemographic variables. While there is an apparent lack of association between stressful life events and breastfeeding initiation, the high prevalence of several stressful life events among pregnant women in Louisiana indicates the need for appropriate screening and referral by prenatal care providers. Although pregnancy intention was not found to be significantly associated with breastfeeding initiation in the present study, pregnancy intention is still a very important indicator of prenatal health behaviors, birth outcomes and subsequent well baby care