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Objectives We examined the breastfeeding attitudes and practices in an American Indian population in Minnesota. Methods We interviewed women prenatally ( n = 380), at 2-weeks ( n = 342) and at 6-months postpartum ( n = 256). We conducted multivariable analyses to examine the demographic, behavioral, and attitudinal correlates of breastfeeding initiation and duration. Results Factors positively associated with breastfeeding initiation included positive breastfeeding attitudes and social support for breastfeeding from the woman’s husband/boyfriend and her mother. Factors positively associated with breastfeeding at 2-weeks postpartum were support from the woman’s mother and positive attitudes about breastfeeding. The prenatal use of traditional American Indian medicines and cigarette smoking were both significantly associated with breastfeeding at 6-months postpartum. Conclusions Programs to encourage breastfeeding in American Indian communities may be strengthened with protocols to encourage social support, recognition of the perceived health, developmental, and practical benefits of breastfeeding, and a focus on traditional American Indian health practices. [ABSTRACT FROM AUTHOR]