Variation in the association between socioeconomic status and breastfeeding practices by immigration status in Taiwan: a population based birth cohort study

Abstract

BackgroundThe relationship between socioeconomic status (SES) and breastfeeding has been extensively discussed in the literature. However, there is some evidence that this relationship can differ with immigration status. To date the majority of research investigating the relationships among SES, breastfeeding and immigration status has been conducted in Europe and the United States with a lack of similar research from Asia. Therefore, the aim of this study was to describe differences in breastfeeding practices between native-born Taiwanese mothers and immigrant mothers in Taiwan and to investigate any differences in the relationship between SES and breastfeeding practices by immigration status.MethodsData analyzed came from the Taiwan Birth Cohort Study, the first longitudinal study of babies in Taiwan with a nationally representative sample born in 2005. In the present study, we included 21,217 mothers or primary caregivers who completed interview surveys when their child was 6 months old. Socioeconomic status was measured by the education level of mothers and fathers, and the couple’s monthly income. Data analysis involved multiple logistic regression. Control variables included residential area, mother’s employment status, age of the father and mother, and sex of the infant.ResultsThe proportion of immigrant mothers predominantly breastfeeding for 4 and for 6 months (Mainland Chinese mothers: 18.25 %, 36.29 %; Southeast Asian mothers: 10.71 %, 24.85 %) was significantly higher than that observed in their Taiwan-born counterparts (7.03 %, 16.22 %). Analysis stratified by immigration status showed that a higher level of parental education was associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, no statistically significant relationship was observed between education and predominantly breastfeeding in immigrant mothers. Higher monthly income was also significantly associated with a greater likelihood of predominantly breastfeeding in Taiwanese mothers. However, there was no significant linear relationship between monthly income and predominantly breastfeeding in immigrant women.ConclusionThe relationship between SES and breastfeeding is different in immigrant mothers and native-born Taiwanese mothers. Taiwanese policy should continue to encourage breastfeeding in immigrant mothers. However, greater attention should be placed on Taiwanese mothers from a low SES background.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0732-8) contains supplementary material, which is available to authorized users.

Breastfeeding rates in immigrant and non‐immigrant women: A systematic review and meta‐analysis

“…Twenty‐eight studies were published between 2001 and 2016; one was published in 1978 (Drew et al, ). Nine studies had cohort designs, (Al Tajir et al, ; Bulk‐Bunschoten et al, ; Hawkins et al, ; Kimbro et al, ; Kuo et al, ; Kwok et al, ; Sussner et al, ; Tavoulari et al, ; Wu et al, ) and 20 were cross‐sectional (Bandyopadhyay et al, ; Besharat Pour et al, ; Busck‐Rasmussen et al, ; De Amici et al, ; Drew et al, ; Farchi et al, ; Forster et al, ; Hawkins et al, ; Kornosky et al, ; Ladewig et al, ; McLachlan & Forster, ; Merten et al, ; Neault, Frank, Merewood et al, ; Oakley et al, ; Philipp et al, ; Rio et al, ; Singh et al, ; Vanderlinden, Levecque, & Van Rossem, ; Verga et al, ; Zuppa et al, ). Eight studies were conducted in the United States (Hawkins et al, ; Kimbro et al, ; Kornosky et al, ; Neault, Frank, Merewood et al, ; Philipp et al, ; Singh et al, ; Sussner et al, ; Vanderlinden et al, ) four in Australia (Bandyopadhyay et al, ; Drew et al, ; Forster et al, ; McLachlan & Forster, ), three in Italy (De Amici et al, ; Farchi et al, ; Zuppa et al, ) two each in Switzerland (Oakley et al, ; Verga et al, ), Taiwan (Kuo et al, ; Wu et al, ) and the United Kingdom (Hawkins et al, ; Oakley et al, ) and one each in Denmark (Busck‐Rasmussen et al, ), Greece (Tavoulari et al, ), Hong Kong (Kwok et al, ), Ireland (Ladewig et al, ), Netherlands (Bulk‐Bunschoten et al, ), Sweden (Besharat Pour et al, ), Spain (Rio et al,…”

“…Eight studies were conducted in the United States (Hawkins et al, ; Kimbro et al, ; Kornosky et al, ; Neault, Frank, Merewood et al, ; Philipp et al, ; Singh et al, ; Sussner et al, ; Vanderlinden et al, ) four in Australia (Bandyopadhyay et al, ; Drew et al, ; Forster et al, ; McLachlan & Forster, ), three in Italy (De Amici et al, ; Farchi et al, ; Zuppa et al, ) two each in Switzerland (Oakley et al, ; Verga et al, ), Taiwan (Kuo et al, ; Wu et al, ) and the United Kingdom (Hawkins et al, ; Oakley et al, ) and one each in Denmark (Busck‐Rasmussen et al, ), Greece (Tavoulari et al, ), Hong Kong (Kwok et al, ), Ireland (Ladewig et al, ), Netherlands (Bulk‐Bunschoten et al, ), Sweden (Besharat Pour et al, ), Spain (Rio et al, ) and the United Arab Emirates (Al Tajir et al, ). Sample sizes ranged from 141 to 1,067,375 women, with most studies including more than 1,000 women (Bandyopadhyay et al, ; Besharat Pour et al, ; Bulk‐Bunschoten et al, ; Busck‐Rasmussen et al, ; Farchi et al, ; Hawkins et al, ; Hawkins et al, ; Kuo et al, ; Kwok et al, ; Ladewig et al, ; Merten et al, ; Neault, Frank, Merewood et al, ; Oakley et al, ; Rio et al, ; Singh et al, ; Vanderlinden et al, ; Wu et al, ; Zuppa et al, ). Twenty‐two studies measured any breastfeeding initiation (Al Tajir et al, ; De Amici et al, ; Drew et al, ; Farchi et al, ; Hawkins et al, ; Hawkins et al, ; Kimbro et al, ; Kornosky et al, ; Kuo et al, ; Kwok et al, ; Ladewig et al,…”

“…Sample sizes ranged from 141 to 1,067,375 women, with most studies including more than 1,000 women (Bandyopadhyay et al, ; Besharat Pour et al, ; Bulk‐Bunschoten et al, ; Busck‐Rasmussen et al, ; Farchi et al, ; Hawkins et al, ; Hawkins et al, ; Kuo et al, ; Kwok et al, ; Ladewig et al, ; Merten et al, ; Neault, Frank, Merewood et al, ; Oakley et al, ; Rio et al, ; Singh et al, ; Vanderlinden et al, ; Wu et al, ; Zuppa et al, ). Twenty‐two studies measured any breastfeeding initiation (Al Tajir et al, ; De Amici et al, ; Drew et al, ; Farchi et al, ; Hawkins et al, ; Hawkins et al, ; Kimbro et al, ; Kornosky et al, ; Kuo et al, ; Kwok et al, ; Ladewig et al, ; McLachlan & Forster, ; Merten et al, ; Neault, Frank, Merewood et al, ; Oakley et al, ; Philipp et al, ; Rio et al, ; Singh et al, ; Sussner et al, ; Tavoulari et al, ; Wu et al, ; Zuppa et al, ), eight studies measured rates of exclusive breastfeeding (Al Tajir et al, ; Besharat Pour et al, ; Bulk‐Bunschoten et al, ; Busck‐Rasmussen et al, ; Kwok et al, ; Merten et al, ; Vanderlinden et al, ; Wu et al, ) and 15 studies measured breastfeeding duration (Al Tajir et al, ; Bandyopadhyay et al, ; Besharat Pour et al, ; Bulk‐Bunschoten et al, ; Forster et al, ; Hawkins et al, ; Kimbro et al, ; Kuo et al, ; Kwok et al, ; Ladewig et al, ; Oakley et al, ; Singh et al, …”

In utero and early childhood exposure to secondhand smoke in Taiwan: a population-based birth cohort study

“…Previous studies have indicated that smoke-free legislation in public places can spill over to the home setting through creating a norm of not smoking around non-smokers. 16 29–32 Indeed, a few studies found that the comprehensive smoke-free laws enacted in 2009 in Taiwan reduced adult non-smokers’ SHS exposure in the home and even increased smoking cessation. 11 14 The enforcement of smoke-free environments in many public places may further reduce women and children’s SHS exposure at home.…”

Early Poverty and Children’s General Health at 8 Years of Age in the Taiwan Birth Cohort Study

“…Child characteristics included demographic factors (sex and birth order), neonatal health status (preterm and low birth weight) and early rearing environment (predominant breastfeeding). Predominant breastfeeding after birth was defined as infants who were predominantly breastfed for more than 120 days after birth (Wu et al 2015). Maternal characteristics included age at birth of child (less than 25 years, 25-29 years, 30-34 years, and more than 35 years), nationality (Taiwan, foreign-born (China, Southeast Asia or others)), and level of education (junior high school or below, senior high school, and college and above).…”