Breastfeeding rates in England during the Covid-19 pandemic and the previous decade: Analysis of national surveys and routine data

Abstract

Background Few studies have compared breastfeeding rates before and during the pandemic using comparable data across time. We used data from two national maternity surveys (NMS) to compare breastfeeding rates in England before and during the pandemic. Methods Analysis was conducted using the NMS from 2018 (pre-pandemic; n = 4,509) and 2020 (during the pandemic; n = 4,611). The prevalence of breastfeeding initiation, and ‘any’ breastfeeding and exclusive breastfeeding (EBF) at 6 weeks and 6 months were compared between these surveys. Data were interpreted in the context of underlying trends in these prevalences from previous NMS (from 2010 and 2014), and annual routine data for England (from 2009–10 to 2020–21). Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the effect of birth during the pandemic (2020 versus 2018) on breastfeeding, with adjustment for sociodemographic and birth-related factors. Results Breastfeeding initiation and any breastfeeding at 6 weeks remained relatively constant in the NMS and the routine data. Birth during the pandemic was associated with a 3 percentage point decrease in EBF at 6 weeks in the NMS (aRR 0.92, 95%CI: 0.87, 0.98 for pandemic versus pre-pandemic), but a smaller decrease in the routine data. Birth during the pandemic was associated with a 3 percentage point increase in any breastfeeding at 6 months in the NMS (aRR 1.05, 95%CI: 1.00, 1.10). Breastfeeding varied across different groups of women in the NMS (i.e. marked inequalities), but the small changes observed between the pandemic and pre-pandemic NMS were broadly similar across the sociodemographic and birth-related factors examined (i.e. no change in inequalities). Conclusion Breastfeeding initiation and any breastfeeding at 6 weeks in England were unaffected by the pandemic, and the persistent inequalities in breastfeeding did not widen. Services should aim to reduce these inequalities in breastfeeding which have been documented since the 1970s.

Donation barriers, enablers, patterns and predictors of milk bank donors in the United States and United Kingdom

“…All milk banks were community-based (vs. hospital-based) for ease of recruitment and had minimum donation requirements that ranged from 2 to 3 L (67 to 100 ounces). For additional context related to breastfeeding: recent breastfeeding initiation rates in the United Kingdom were 84.7% compared with 83.2% in the United States; exclusive breastfeeding rates at 6 months were 18.0% in the United Kingdom and 24.9% in the United States; and according to the 2023 Global Breastfeeding Score, countries in the Americas score lower on legislation for maternity leave and paid nursing breaks than their European counterparts (CDC, 2022;Quigley et al, 2023;WHO & UNICEF, 2023).…”