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Abstract
BackgroundData from the UK Infant Feeding Surveys indicate that breastfeeding initiation increased between 1985 and 2010. During this period, societal changes in GB also influenced the sociodemographic characteristics of women in the childbearing population. As breastfeeding behaviour is highly socially patterned in GB, the increasing trend in breastfeeding initiation may have hidden inequalities in breastfeeding practices. This study examines the sociodemographic inequalities in breastfeeding initiation in GB between 1985 and 2010, exploring whether and how this may have been influenced by social and policy changes.MethodsData drawn from the nationally representative 1985, 1990, 1995, 2000, 2005 and 2010 Infant Feeding Surveys were used to estimate changes in the proportion of mothers in selected sociodemographic groups over time. Logistic regression models estimated the independent associations between breastfeeding initiation in each survey year and maternal sociodemographic characteristics. Associations were adjusted for maternal sociodemographic, pregnancy-related and support factors. Evidence of a change in the association between breastfeeding initiation and each sociodemographic characteristic over time was assessed using a test for statistical heterogeneity.ResultsThe sociodemographic characteristics of mothers in GB changed substantially between 1985 and 2010. Mothers were increasingly more likely to be 30 or over; have higher education and socioeconomic status; and be single or cohabiting. An increasing proportion of mothers in GB identified as being of black or minority ethnic origin. Reported smoking in pregnancy declined. These same characteristics independently predicted higher odds of breastfeeding initiation; the associations between these characteristics and breastfeeding initiation did not vary significantly over time.ConclusionsMarked inequalities in breastfeeding initiation persisted over the study period, hidden among the increasing initiation rate at the population level. The increasing overall rate of initiation was most likely driven by the rising prevalence of those groups of mothers who were, and remain, characteristically most likely to breastfeed.
Highlights
The World Health Organisation recommends exclusive breastfeeding for the first 6 months after birth, followed by continued breastfeeding alongside safe and appropriate foods until at least 2 years [1]
The proportion of mothers who participated in higher education increased dramatically from 14% in 1985 to 51% in 2010 (Fig 1)
There was an increase in the proportion of mothers who self-identified as being of BME origin compared to being white, rising from 6.9% in 2000 to 14.1% in 2010
Summary
The World Health Organisation recommends exclusive breastfeeding for the first 6 months after birth, followed by continued breastfeeding alongside safe and appropriate foods until at least 2 years [1]. Between 1985 and 2010, the rate of breastfeeding initiation increased from 64% to 81%, and the rate of breastfeeding continuation at six months among all mothers rose from 21% to 34% [5]. These increasing trends are encouraging, evidence from several studies suggests the presence of sociodemographic disparities in the practise of breastfeeding in GB. Data from the UK Infant Feeding Surveys indicate that breastfeeding initiation increased between 1985 and 2010. During this period, societal changes in GB influenced the sociodemographic characteristics of women in the childbearing population. This study examines the sociodemographic inequalities in breastfeeding initiation in GB between 1985 and 2010, exploring whether and how this may have been influenced by social and policy changes
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