Breastfeeding Rates Among Singletons, Twins and Triplets in Japan: A Population-Based Study

Abstract

This study was performed to determine the rates of breastfeeding among singletons, twins and triplets in Japan, and identify factors associated with the decision to breastfeed or bottle-feed. We analyzed a database of medical check-up of infants aged 3 to 6 months between April 2001 and July 2004 in Nishinomiya City in Japan. This medical check-up is given to almost 100% of infants in Japan and the data of 15,262 infants were analyzed. Among these, 14,963 (98.0%) were singletons, 290 (1.9%) were twins and 9 (0.1%) were triplets. Exclusive breast-feeding was chosen by 6680 (43.8%) mothers, mixed-feeding by 4645 (30.4%) mothers, and bottle-feeding with formula milk only by 3900 (25.6%) mothers. The rate of exclusive breastfeeding among twins or triplets was significantly lower than among singleton babies: 4.1% among twins or triplets, and 44.7% among singletons. Moreover, twins and triplets were independently associated with a higher rate of bottle-feeding: the odds ratio indicated that mothers who had twins or triplets were 2.44 times more likely to choose bottle-feeding with formula milk only than those who had singletons. Sucking ability at birth was associated with a higher rate of bottle-feeding: the odds ratio indicated that mothers who had infants with poor sucking ability at birth were 1.56 times more likely to choose bottle-feeding as those who had infants with normal sucking ability.

Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study

“…Similar to our findings, previous studies suggested a dose–response relationship between parity, and breastfeeding initiation and exclusivity among mothers of both singleton and twin infants [23,26,36,74,83]. Another study found that first-born children were more likely to be weaned early and introduced to cow’s milk and formula early [84].…”

Prevalence and Associated Factors of Minor Neuromotor Dysfunctions at Age 5 Years in Prematurely Born Children

“…However, a weakness of our study was that the only information we had was breastfeeding at discharge from the neonatal unit without any information on the duration of breastfeeding. Consistent with previous studies, 54 our findings showed that breastfeeding was signifi- cantly less frequent in twins (17.3%) than in singletons (24.7%) (P=.002). It is also likely that the duration of breastfeeding was shorter for multiple births.…”

Infant feeding practices and breastfeeding duration in Japan: A review

“…A population based study of 15,262 infants confirmed that the mean age of mothers who chose formula feeding was significantly younger than those who chose ‘full’ and ‘Any Breastfeeding’ (p < 0.001) [21]. This study was cross-sectional and analysed a database of infants aged three to six months attending for medical examinations, which has a very high response rate in Japan.…”

“…In contrast, a study using data from the National Survey of 46,569 infants showed that mothers in their 30s and 40s were less likely to continue Exclusive Breastfeeding at six months postpartum than mothers in their 20s (aOR = 0.89, 95% CI = 0.84-0.94 for their 30s; aOR = 0.56, 95% CI = 0.48-0.65 for their 40s, respectively) [20]. The National Survey used a cross-sectional study design and found different results to the study by Yokoyama et al [21]. Moreover, Sasaki et al found no correlation between maternal age and Exclusive Breastfeeding at four months postpartum in a longitudinal study (p = 0.93, n = 908) [23].…”

“…Low birth weight infants (less than 2500g) were less likely to be breastfed at six months (aOR = 0.67, 95% CI = 0.60-0.76) [20]. Similarly, Yokoyama et al [21] found that mothers with multiple births were 2.44 times more likely to choose bottle feeding than those who had a singleton birth. However, the full breastfeeding rate of twins has not changed over 30 years with a study of 4,023 twins born between 1968 and 2003 showing that the rate of full breastfeeding at one month postpartum was steady at 16.8% between 1975 and 1984 and 16.7% between 1995 and 2003 [24].…”