Factors associated with breastfeeding in England: an analysis by primary care trust

Oakley, Laura; Renfrew, Mary J; Kurinczuk, Jennifer J; Quigley, Maria A.

doi:10.1136/bmjopen-2013-002765

Cited by 73 publications

(76 citation statements)

References 28 publications

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“…A recent analysis of area‐based breastfeeding rates in England found some of these associations (notably maternal age, deprivation and ethnicity) prevailed at the area level (Oakley et al . ), and the wide disparity in area‐based breastfeeding rates was also highlighted in the most recent annual report by the Chief Medical Officer for England (Lemer, ).…”

Section: Introductionmentioning

confidence: 93%

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

Oakley

Kurinczuk

Renfrew

et al. 2014

Maternal & Child Nutrition

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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.

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Section: Introductionmentioning

confidence: 93%

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

Oakley

Kurinczuk

Renfrew

et al. 2014

Maternal & Child Nutrition

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“…Recent survey data also indicate that despite legal protections considerable cultural discomfort remains with public breastfeeding, with over a third of mothers hesitant to breastfeed in public (Public Health England, 2015) Mixed breastfeeding and formula feeding also become more common over the course of the first year in the U.S., and in many communities neither exclusive breastfeeding (Cartagena et al, 2014; Morrison et al, 2008) nor breastfeeding in public (Fischer & Olson, 2014; Mitchell-Box & Braun, 2012) are common cultural practices. Moreover, both settings share disparities in breastfeeding by socioeconomic status, education, race and ethnicity (McAndrew et al, 2012; Oakley et al, 2013), but ethnic minorities are more likely to breastfeed in the U.K. (Griffiths & Tate, 2007; McAndrew et al, 2012), whereas many racial and ethnic minorities in the U.S., especially African American women, are considerably less likely to breastfeed than white women (Centers for Disease Control and Prevention, 2016). Finally, although cultural support and breastfeeding activism has increased in both settings breastfeeding remains controversial, as described above.…”

Section: Introductionmentioning

confidence: 99%

Contested moral landscapes: Negotiating breastfeeding stigma in breastmilk sharing, nighttime breastfeeding, and long-term breastfeeding in the U.S. and the U.K.

Tomori

Palmquist

Dowling

2016

Social Science & Medicine

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Recent public health breastfeeding promotion efforts have galvanized media debates about breastfeeding in wealthy, Euro-American settings. A growing body of research demonstrates that while breastfeeding is increasingly viewed as important for health, mothers continue to face significant structural and cultural barriers. Concerns have been raised about the moralizing aspects of breastfeeding promotion and its detrimental effects on those who do not breastfeed. Far less, however, is known about the moral experiences of those who pursue breastfeeding. This study draws together research on breastmilk sharing (2012–2016) and nighttime breastfeeding from the U.S. (2006–2009), and long-term breastfeeding from the U.K. (2008–2009) from three ethnographic projects to address this gap. Comparative analysis of these cases reveals that while breastfeeding is considered ideal infant nutrition, aspects of its practice continue to evoke physical and moral danger, even when these practices are implemented to facilitate breastfeeding. Breastmilk sharing to maintain exclusive breastmilk feeding, nighttime breastfeeding and bedsharing to facilitate breastfeeding, and breastfeeding beyond the accepted duration are considered unnecessary, unhealthy, harmful or even deadly. The sexual connotations of breastfeeding enhance the morally threatening qualities of these practices. The cessation of these “problematic” breastfeeding practices and their replacement with formula-feeding or other foods is viewed as a way to restore the normative social and moral order. Mothers manage the stigmatization of these breastfeeding practices through secrecy and avoidance of health professionals and others who might judge them, often leading to social isolation. Our findings highlight the divide between perceptions of the ideal of breastfeeding and its actual practice and point to the contested moral status of breastfeeding in the U.S. and the U.K. Further comparative ethnographic research is needed to illuminate the lived social and moral experiences of breastfeeding, and inform initiatives to normalize and support its practice without stigmatizing parents who do not breastfeed.

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“…However, prevalence of both exclusive and any breastfeeding still declines rapidly in the first two months [6,7]. These patterns have been observed in multiple urban cities not only within the UK [8] but also worldwide [9-11]. …”

Section: Introductionmentioning

confidence: 99%

What factors explain pregnant women’s feeding intentions in Bradford, England: A multi-methods, multi-ethnic study

Cabieses

Waiblinger

Santorelli

et al. 2014

BMC Pregnancy Childbirth

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BackgroundUsing a multi-methods approach we aimed to explore the relative prediction of demographic, socioeconomic and modifiable predictors from the Theory of Planned behaviour (TPB) in explaining feeding intentions amongst a multi-ethnic sample.Methods476 women completed a questionnaire at 28 weeks gestation. They were grouped into breastfeeding (N = 258), mixed-feeding (N = 50), bottle-feeding (N = 88) intenders, or a no clear intention (N = 88). Multinomial adjusted regressions explored the influence of modifiable TPB factors, along with ethnicity and socioeconomic status in predicting group membership. Free-text responses allowed women to elaborate on reasons behind their intention.ResultsTPB factors were significant predictors of feeding intention. Women with high intention to breastfeed were less likely to report high attitudes in any other feeding alternative. Bottle-feeding intenders reported poorer self-efficacy regarding breastfeeding compared to breastfeeding intenders (prevalence rate ratio, PRR = 0.10). Mixed and bottle-feeding intenders reported greater self-efficacy for mixed-feeding (PRR = 1.80, 5.50 respectively). Descriptive norms for mixed (PRR = 13.77) and bottle-feeding (PRR = 10.68) were predictive of mixed-feeding intention. Reasons for breastfeeding intentions related to health considerations, whilst bottle-feeding reasons related to convenience. Mixed-feeding intenders reported both breast and bottle-related factors.ConclusionsUnderstanding modifiable predictors related to feeding intentions like TPB factors can help professionals target appropriate interventions to encourage breastfeeding.

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Factors associated with breastfeeding in England: an analysis by primary care trust

Cited by 73 publications

References 28 publications

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

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

Contested moral landscapes: Negotiating breastfeeding stigma in breastmilk sharing, nighttime breastfeeding, and long-term breastfeeding in the U.S. and the U.K.

What factors explain pregnant women’s feeding intentions in Bradford, England: A multi-methods, multi-ethnic study

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