Breastfeeding in England: time trends 2005–2006 to 2012–2013 and inequalities by area profile

Abstract

Breastfeeding rates in England have risen steadily since the 1970s, but rates remain low and little is known about area-based trends. We report an ecological analysis of time trends in area breastfeeding rates in England using annual data on breastfeeding initiation (2005-2006 to 2012-2013) and any breastfeeding at 6-8 weeks (2008-2009 to 2012-2013) for 151 primary care trusts (PCTs). Overall, breastfeeding initiation rose from 65.5% in 2005-2006 to 72.4% in 2012-2013 (average annual absolute increase 0.9%). There was a statistically significantly higher (interaction P < 0.001) annual increase in initiation in PCTs in the most deprived (1.2%) compared with the least deprived tertile (0.7%), and in PCTs with low baseline breastfeeding initiation (2005-2006; 1.4%) compared with high baseline initiation (0.6%). Similar trends were observed when PCTs were stratified by the proportion of teenage mothers and maternal smoking, but not when stratified by ethnicity. Although breastfeeding prevalence at 6-8 weeks also increased significantly over the observed time period (41.2% in 2008-2009, 43.7% in 2012-2013; annual increase 0.7%), there was no difference in the average increase by deprivation profile, ethnicity, teenage mothers and maternal smoking. However, PCTs with low baseline prevalence in 2008-2009 saw a significantly larger annual increase (0.8%) compared with PCTs with high baseline prevalence (0.07%). In conclusion, breastfeeding initiation and prevalence have seen higher increases in areas with low initial breastfeeding, and for initiation, more disadvantaged areas. Although these results suggest that inequalities in breastfeeding have narrowed, rates have plateaued since 2010-2011. Sustained efforts are needed to address breastfeeding inequalities.

Associations between breastfeeding rates and infant disease: A survey of 2338 Czech children

“…Rates of overall breastfeeding initiation in the present study sample were 97.8%, including 82.6% full breastfeeding and 15.2% partial breastfeeding, similar to the data collected by the IHISCR and comparable with rates in some other countries . At the age of 3 months, full breastfeeding rates increased up to 87.3%, with an overall breastfeeding rate of 95.1%, and only dropped to 67% (with an overall breastfeeding rate of 90.0%) by 6 months.…”

“…We ascribe this apparent discrepancy to the high rate of tertiary‐educated mothers in our survey (60.1% vs 31.7% in the general population between 25–29 years of age in the Czech Republic in 2015 according to the Czech Statistical Office) . College‐educated mothers have been shown to exhibit higher rates of breastfeeding in our own and other studies . A second important factor augmenting breastfeeding rates among the present study population may be related to the longer maternity leave in our country (28 weeks, compared to the Organisation for Economic Co‐operation and Development (OECD) average of 19.1 weeks) followed by parental leave for another 134 weeks (OECD average of 65.7 weeks) .…”

Twenty-five-year trends in breastfeeding initiation: The effects of sociodemographic changes in Great Britain, 1985-2010

“…Although these increasing trends are encouraging, evidence from several studies suggests the presence of sociodemographic disparities in the practise of breastfeeding in GB. In particular, breastfeeding initiation and continuation rates are highest among mothers who have higher education; who are older; who are married or living with a partner; from higher socioeconomic groups; and who are of black and minority ethnicity [6–11]. Therefore, it is possible that the increasing breastfeeding rates from 1985 to 2010 masked inequalities in breastfeeding practices between groups of mothers.…”

Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study

“…We included several infant and maternal characteristics known to be important for predicting breastfeeding outcomes: birthweight [ 96 ], maternal age [ 97 ], partnership status [ 98 ], parity [ 65 , 99 , 100 ], ethnicity [ 101 ], immigration and acculturation [ 102 ].…”