Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-10T12:35:46.562Z Has data issue: false hasContentIssue false
  • English
  • Français

Breast-feeding in a UK urban context: who breast-feeds, for how long and does it matter?

Published online by Cambridge University Press:  02 January 2007

Charlotte M Wright ,
Kathryn Parkinson  and
Jane Scott
Charlotte M Wright*
Affiliation:
Department of Child Health, Glasgow University, PEACH Unit, QMH Tower, Yorkhill Hospitals, Glasgow G3 8SJ, UK
Kathryn Parkinson
Affiliation:
Department of Child Health, Newcastle University, Newcastle upon Tyne, UK
Jane Scott
Affiliation:
Department of Human Nutrition, Glasgow University, Glasgow, UK
*
*Corresponding author: Email charlotte.wright@clinmed.gla.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To investigate what factors relate most strongly to breast-feeding duration in order to successfully support breast-feeding mothers.

Design

Prospective birth cohort study using questionnaires, routinely collected weights and health check at age 13 months.

Setting

Gateshead, UK.

Subjects

Parents of 923 term infants born in a defined geographical area and recruited shortly after birth, 50% of whom were breast-feeding initially.

Results

Only 225 (24%) infants were still breast-fed at 6 weeks, although 136 (15%) continued beyond 4 months. Infants in the most affluent quintile were three times more likely to be initially breast-fed (P < 0.001) and five times more likely to still be feeding at 4 months (P = 0.001) compared with infants in the most deprived quintile. A third of breast-fed infants were given supplementary feeds in the maternity unit and this was associated with a 10-fold increase in odds of giving up breast-feeding by discharge (P = 0.001). Frequent feeding was reported as a reason for giving up in 70% of mothers at 6 weeks and 55% at 4 months. Those infants who stopped breast-feeding earliest showed the most rapid weight gain and were tallest at age 13 months. Non-breast-fed infants had 50% more family doctor contacts up to age 4 months (P = 0.005).

Conclusions

Initiation of breast-feeding in urban Britain remains strongly determined by socio-economic background and early cessation seems to be related to frequent feeding and rapid growth as well as a continuing failure to eradicate health practices that undermine breast-feeding. Those infants not receiving breast milk suffered increased morbidity, but the apparent association between breast-feeding duration and growth probably reflects reverse causation.

Keywords

Breast-feedingMaternity wards practiceSocial deprivationGrowthMorbidity
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 6 , September 2006 , pp. 686 - 691
Copyright
Copyright © The Authors 2006

References

1WHO. Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality. Lancet 2000; 355: 451–5.CrossRefGoogle Scholar
2Betran, AP, de Onis, M, Lauer, JA, Villar, J. Ecological study of effect of breastfeeding on infant mortality in Latin America. British Medical Journal 2001; 323: 303–6.CrossRefGoogle ScholarPubMed
3Huffman, SL, Zehner, ER, Victora, C. Can improvements in breastfeeding practices reduce neonatal mortality in developing countries? Midwifery 2001; 17: 80–92.CrossRefGoogle ScholarPubMed
4Kramer, MS, Kakuma, R. Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews 2002; (1): CD003517.CrossRefGoogle ScholarPubMed
5Oddy, WH, Sly, PD, de Klerk, NH, Landau, LI, Kendall, GE, Holt, PG, et al. Breastfeeding and respiratory morbidity in infancy: a birth cohort study. Archives of Disease in Childhood 2003; 88: 224–8.Google Scholar
6Chen, A, Rogan, WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics 2004; 113: e435–9.Google Scholar
7Lucas, A, Morley, R, Cole, T, Lister, G, Leeson-Payne, C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339: 261–4.Google Scholar
8Singhal, A, Cole, TJ, Lucas, A. Early nutrition in preterm infants and later blood pressure: two cohorts after randomised trials. Lancet 2001; 357: 413–9.CrossRefGoogle ScholarPubMed
9Hamlyn, B, Brooker, S, Oleinikova, K, Wands, S. Infant Feeding 2000. London: Department of Health, 2003.Google Scholar
10Hoddinott, P, Pill, R. Qualitative study of decisions about infant feeding among women in east end of London. British Medical Journal 1999; 318: 30–4.Google Scholar
11Scott, JA, Mostyn, T. Women's experiences of breastfeeding in a bottle-feeding culture. Journal of Human Lactation 2003; 19: 270–7.CrossRefGoogle Scholar
12Cooke, M, Sheehan, A, Schmied, V. A description of the relationship between breastfeeding experiences, breastfeeding satisfaction, and weaning in the first 3 months after birth. Journal of Human Lactation 2003; 19: 145–56.Google Scholar
13Casiday, RE, Wright, CM, Panter-Brick, C, Parkinson, KN. Do early infant feeding patterns relate to breastfeeding continuation and weight gain? Data from a longitudinal cohort study. European Journal of Clinical Nutrition 2004; 58: 1290–6.Google Scholar
14Wright, P. Development of feeding behaviour in early infancy: implications for obesity. Health Bulletin 1981; 39: 197–205.Google Scholar
15Dewey, KG, Peerson, JM, Brown, KH, Krebs, NF, Michaelsen, KF, Persson, LA, et al. Growth of breastfed infants deviates from current reference data: a pooled analysis of US, Canadian, and European data sets. World Health Organization Working Group on Infant Growth. Pediatrics 1995; 96: 495–503.CrossRefGoogle Scholar
16Townsend, P, Phillimore, P, Beattie, A. Health and Deprivation: Inequality and the North. London: Croom Helm, 1988.Google Scholar
17Freeman, JV, Cole, TJ, Chinn, S, Jones, PRM, White, EM, Preece, MA. Cross sectional stature and weight reference curves for the UK, 1990. Archives of Disease in Childhood 1995; 73: 17–24.Google Scholar
18Preece, M, Freeman, J, Cole, T. Sex differences in weight in infancy. Published centile charts have been updated. British Medical Journal 1996; 313: 1486.CrossRefGoogle ScholarPubMed
19Wright, CM, Parkinson, KN, Drewett, RF. Why are babies weaned early? Data from a prospective population based cohort study. Archives of Disease in Childhood 2004; 89: 813–6.Google Scholar
20Wright, CM, Waterston, A, Matthews, JNS, Aynsley-Green, A. What is the normal rate of weight gain in infancy? Acta Paediatrica 1994; 83: 351–6.Google Scholar
21Ekstrom, A, Widstrom, AM, Nissen, E. Duration of breastfeeding in Swedish primiparous and multiparous women. Journal of Human Lactation 2003; 19: 172–8.Google Scholar
22Alder, EM, Williams, FL, Anderson, AS, Forsyth, S, Florey, CduV, van der Velde, P. What influences the timing of the introduction of solid food to infants? British Journal of Nutrition 2004; 92: 527–31.Google Scholar
23Kramer, MS, Chalmers, B, Hodnett, ED, Sevkovskaya, Z, Dzikovich, I, Shapiro, S, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. Journal of the American Medical Association 2001; 285: 413–20.Google Scholar
24Cole, TJ, Paul, AA, Whitehead, RG. Weight reference charts for British long-term breastfed infants. Acta Paediatrica 2002; 91: 1296–300.Google Scholar
25Singhal, A, Lucas, A. Early origins of cardiovascular disease: is there a unifying hypothesis? Lancet 2004; 363: 1642–5.Google Scholar
26Kramer, MS, Guo, T, Platt, RW, Shapiro, S, Collet, JP, Chalmers, B, et al. Breastfeeding and infant growth: biology or bias? Pediatrics 2002; 110: 343–7.CrossRefGoogle ScholarPubMed