Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden

Abstract

Hörnell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M. Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatr 1999; 88: 203-11. Stockholm. ISSN 0803-5253 Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to put pressure on individual families to adopt preconceived patterns of infant feeding.

Pathways of equality through education: impact of gender (in)equality and maternal education on exclusive breastfeeding among natives and migrants in Belgium

“…The other research aims focus on the universality of the association between maternal education EBF, something that has received much attention in previous studies (Colodro-Conde et al 2011), leading it to be incorporated as a control variable in a wide array of other studies. There is a universal assumption that a higher maternal education leads to higher breastfeeding rates in developed nations (Hörnell et al 1999;Bertini et al 2003;Colodro-Conde et al 2011). Our design allowed us to test whether this association is positive across all population groups in Belgium, which was our second research aim, or if the educational benefits are stronger for some groups compared to others, which was our third research aim.…”

“…Women's access to education has long been recognized as a fundamental right and a central policy aim of many international communities and countries (Kabeer 2005). In this study, education is especially relevant: empirical research has shown its well-established role in infant feeding decisions (Hörnell et al 1999;Bertini et al 2003;Colodro-Conde et al 2011;Raffle et al 2011); it is considered as a more fixed indicator of the mothers socio-economic status (Kwok & Yankaskas 2001;Heck et al 2006), and there is a demonstrated close link between education and gender equality (Malhotra et al 2003). This connection is most visible on issues of maternal health (Malhotra et al 2003), where education is positively associated with higher use of maternal care services and improved health outcomes.…”

“…In developed countries, many studies have demonstrated a strong positive association between higher maternal education and longer duration of (exclusive) breastfeeding (Hörnell et al 1999;Bertini et al 2003;Colodro-Conde et al 2011). Mothers with a higher education are generally better informed and understand the health benefits related to breastfeeding better (Raffle et al 2011).…”

Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates

“…Research suggested that complementary foods offered to infants before 6 months of age tend to displace breastmilk without conferring any growth advantage over exclusive breastfeeding [44]. Early introduction of other foods or drinks is an area of concern mainly because it marks the end of exclusive breastfeeding which has protective effects [45]. …”

How Breastfeeding Works

“…Detailed studies show that not only do babies show a three-fold variation in the amount they take per day, they also show a wide variation in their patterns of milk intake. 33,50 During a meal or a breastfeeding session, the baby may feed from one breast only (an unpaired breastfeed), feed from both breasts within 30 minutes (two paired breastfeeds), or the baby may have a cluster of breastfeeds (feeding again from the first breast within 30 minutes of feeding on the second). In a recent study of exclusively breastfeeding babies between 1 and 6 months old in Western Australia, 33 13% of babies always took paired breastfeeds, 30% of babies always took unpaired breastfeeds, and most babies had paired and unpaired breastfeeds.…”