Breastfeeding Rates Among Singletons, Twins and Triplets in Japan: A Population-Based Study

Abstract

This study was performed to determine the rates of breastfeeding among singletons, twins and triplets in Japan, and identify factors associated with the decision to breastfeed or bottle-feed. We analyzed a database of medical check-up of infants aged 3 to 6 months between April 2001 and July 2004 in Nishinomiya City in Japan. This medical check-up is given to almost 100% of infants in Japan and the data of 15,262 infants were analyzed. Among these, 14,963 (98.0%) were singletons, 290 (1.9%) were twins and 9 (0.1%) were triplets. Exclusive breast-feeding was chosen by 6680 (43.8%) mothers, mixed-feeding by 4645 (30.4%) mothers, and bottle-feeding with formula milk only by 3900 (25.6%) mothers. The rate of exclusive breastfeeding among twins or triplets was significantly lower than among singleton babies: 4.1% among twins or triplets, and 44.7% among singletons. Moreover, twins and triplets were independently associated with a higher rate of bottle-feeding: the odds ratio indicated that mothers who had twins or triplets were 2.44 times more likely to choose bottle-feeding with formula milk only than those who had singletons. Sucking ability at birth was associated with a higher rate of bottle-feeding: the odds ratio indicated that mothers who had infants with poor sucking ability at birth were 1.56 times more likely to choose bottle-feeding as those who had infants with normal sucking ability.

Breast-feeding rates and related maternal and infants’ obstetric factors in Japanese twins

“…Since the report of Addy [52], many other reports [15,30,31,36,38,49,[53][54][55][56][57] have been completed, with a variety of levels of reliability and verifiability. Although reports from a Western maternal association group [17,39] contained a large sample size, detailed statistic analyses of the data were not performed.…”

“…There also exist case reports [21][22][23][24], including triplets [25,26] and quadruplets [18,27], and detailed descriptions of breast-feeding multiples with relatively small sample sizes [2,15,25,28,29]. Some reports [30][31][32][33][34][35][36][37][38] deal with multiples in comparison with singletons or control groups, or treat multiple births as a risk factor.…”

Does Breastfeeding Behavior Run in Families? Evidence From Twins, Their Sisters and Their Mothers in the Netherlands

“…Formula and bottle-feeding increase an infant's weight more rapidly than breastfeeding (Gibbs & Forste, 2014), and because twins are born with a lower birth weight, mothers may want to compensate for this with formula feeding. In addition, premature or low birth weight twins have poorer sucking ability, which is related to lower probability to initiate breastfeeding (Yokoyama et al, 2006). Several demographic, psychosocial, cultural, attitudinal, and societal changes are suggested to have influenced the increase in the prevalence of the initiation of breastfeeding.…”

Breastfeeding practices and parental employment in Japan

“…Using the Longitudinal Survey of Babies in the Twenty-first Century, Kaneko et al (2006) examine factors associated with exclusive breastfeeding during the first 6 months of life in Japan and find that low birth-weight and multiple births are negatively associated with exclusive breastfeeding. Similarly, Yokoyama et al (2006) use a database of medical check-ups of infants aged 3-6 months in Nishinomiya City in Japan, and also find that mothers who give birth to multiples are more likely to bottle-feed with only formula milk than those who had singletons.…”