Effectiveness of a community-based support programme to reduce social inequality in exclusive breastfeeding: study protocol for a cluster-randomised trial

BackgroundExclusive breastfeeding for the first 6 months followed by ongoing breastfeeding to 12 months and beyond is associated with multiple benefits for both mother and child. Maternal smoking is associated with a reduction in breastfeeding. Little is known about the effect of partner smoking on breastfeeding.AimsThis study explores the smoking behaviour of mothers and their partners in the first two years of a child's life and its associations with breastfeeding practice.Materials and MethodsWe performed a secondary data analysis using survey data on 1155 mothers from their third trimester of pregnancy and at six, 12 and 24 months after delivery. Survey questions included smoking status of both mother and partner and breastfeeding intention and practice. Logistic regression models were conducted at each time point.FindingsWhere the mother or both parents smoke, babies were less likely to be breastfed at six months of age (adjusted odds ratio (aOR) 0.29, 95% CI: 0.13–0.66) compared with families where neither parent smoked. Non‐smoking mothers with smoking partners were less likely to intend to breastfeed (aOR 0.29, 95% CI: 0.11–0.82) and their babies were less likely to be breastfed at six and 12 months of age (aOR 0.64, 95% CI: 0.42–0.98 and 0.64, 95% CI: 0.43–0.95 respectively). There was no difference in breastfeeding behaviour between smoking and non‐smoking parents at 24 months.ConclusionSmoking parents are less likely to breastfeed their babies at ages six and 12 months. Breastfeeding promotion should target both smoking mothers and smoking partners.

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Trends in social inequality in breastfeeding duration in Denmark 2002–2019

Carlsson,

Pommerencke,

Pant

et al. 2024

Scand J Public Health

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Aims: The aim of the present study was to analyse trends in full breastfeeding for at least 4 months across socioeconomic position in Denmark over a 17-year-long period from 2002 to 2019 using parental education as the indicator of socioeconomic position. Methods: The study used data on full breastfeeding collected between 2002 and 2019 by community health nurses in the collaboration Child Health Database, n=143,075. Data were linked with five categories of parental education from population registers. Social inequality was calculated as both the relative (odds ratio) and absolute social inequality (slope index of inequality). A trend test was conducted to assess changes in social inequality over time. Results: A social gradient in full breastfeeding was found for the entire study period. The odds ratio for not being fully breastfed for at least 4 months ranged from 3.30 (95% confidence interval 2.83–3.84) to 5.09 (95% confidence interval 4.28–6.06) during the study period for infants of parents with the lowest level of education (primary school) compared with infants of parents with the highest level of education (5+ years of university education). The slope index of inequality was between −38.86 and −48.81 during the entire study period, P=0.80. This indicated that both the relative and absolute social inequality in full breastfeeding to at least 4 months of age was unchanged in the study period from 2002 to 2019. Conclusions: This study showed a persistent relative and absolute social inequality in full breastfeeding for at least 4 months from 2002 to 2019 in Denmark.

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Effectiveness of a community-based support programme to reduce social inequality in exclusive breastfeeding: study protocol for a cluster-randomised trial

Cited by 5 publications

References 46 publications

Strengthening health visitors’ breastfeeding support: Results from a cluster randomised study

Strengthening health visitors’ breastfeeding support: Results from a cluster randomised study

Parental smoking in the first two years of a child's life and its associations with breastfeeding

Trends in social inequality in breastfeeding duration in Denmark 2002–2019

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