Association between maternal education and breast feeding practices in China: a population-based cross-sectional study

Abstract

ObjectiveTo investigate the association between maternal education and breast feeding in the Chinese population, with a consideration of household income and health-seeking behaviours.DesignA nationally representative population-based cross-sectional study.Setting77 counties from 12 geographically distinct regions in China.Participants10 408 mothers with children from 0 to 12 months of age, aged 15–53 years old (mean: 29.15, SD: 5.11) were classified into primary school or below group (n=781), middle school group (n=3842), high school/vocational school group (n=1990), college or above group (n=3795), according to their highest completed education.OutcomesFive breastfeeding outcomes, including early initiation of breast feeding (EIB), exclusive breast feeding (EBF) under 6 months, predominant breast feeding under 6 months, current breast feeding and children ever breast fed, were calculated based on the standardised questionnaire from the WHO and Wellstart International’s toolkit for monitoring and evaluating breastfeeding activities.ResultsThe absolute risk of EIB and EBF in the lowest maternal education level was 64.85% and 26.53%, respectively, whereas the absolute risk of EIB and EBF in the highest maternal education level was 77.21% and 14.06%, respectively. A higher level of maternal education was positively associated with EIB (risk ratio (RR): 1.22; 95% CI: 1.12 to 1.30) and was inversely associated with EBF (RR: 0.59; 95% CI: 0.38 to 0.88). Stratified by household income, a positive association with EIB was observed only in the group with the highest household income and an inverse association with EBF was found in both low household and high household income groups.ConclusionsMothers with a higher education were more likely to initiate early breast feeding when they were also from a high-income household while also being less likely to exclusively breast feed their babies. Routine and successful nursing is crucial for the health of infants and is influenced by maternal education. Future public health interventions to promote breast feeding should consider the issues related to the educational level of mothers.

The Rate and Influencing Factors of Exclusive Breastfeeding for the First 6 Months in Nanjing, China

“…However, the <¥5,000 group had the second-lowest rate among the four groups, indicating that the economic advantage may not be the reason. Our results showed that women with a higher education level more readily fed the infants with milk formula, which was similar to other ndings [12,14] The women with a higher education level generally have more busy work lives and a higher family income [15] . Therefore, we also speculated that women with a high monthly family income or high education level were likely to go back to work early and must take more time for their work, and this may be the reason for the lower exclusive breastfeeding rate among these women.…”

“…Therefore, many of the policies formulated by our government to a certain extent play an important role in promoting breastfeeding. In our study, the rate of exclusive breastfeeding for six months reached 29.4% and was higher than that of a large national representative survey conducted by Tang Kun et.ac in 2018, with the rate of 15.4% [12] .…”

Socioeconomic Factors Affecting Exclusive Breastfeeding in the First 6 Months of Life

“…Generally, mothers who had higher literacy levels were also more likely to participate in pre-pregnancy, pregnancy, and lactation period classes and had higher health literacy too. According to Tang et al, EBF rates will increase with increase in mothers' literacy, however, they stated that the positive impact of high literacy on breastfeeding is higher in families with higher incomes (24). The importance of this issue is that future plans for the promotion of EBF should pay more attention to the promotion of maternal literacy.…”

Parental Socioeconomic Status as a determinant of breastfeeding : an analysis of the Korea National Health and Nutrition Examination Survey ( 2013 ~ 2017 )

“…In high-income countries, mother's education level is positively associated with higher breastfeeding rate. 16,17,19,[21][22][23][24][25] Even for mothers with a job, breastfeeding rate is estimated to be high, because the higher the level of education, the higher the occupational status, the better the working environment and the better knowing the bene ts of breastfeeding. In middle-and low-income countries, the relationship between breastfeeding and mothers' education level varies.…”