The Validity and Reliability of Maternal Recall of Breastfeeding Practice

Objective: To examine UK country and ethnic variations in infant feeding practices. Design: Cohort study. Setting: Infants enrolled in the Millennium Cohort Study, born between September 2000 and January 2002. Subjects: A total of 18 150 natural mothers (11 286 (8207 white) living in England) of singleton infants. Outcome measures: Breast-feeding initiation, breast-feeding discontinuation and introduction of solid foods before 4 months. Explanatory variables: Maternal ethnic group, education and social class. Results: Seventy per cent of UK mothers started to breast-feed, of whom 62% stopped before 4 months. Median age at discontinuing breast-feeding was 14, 13, 10 and 6 weeks in Scotland, England, Wales and Northern Ireland, respectively. Thirty-six per cent of UK mothers (34% in England) introduced solids before 4 months. White mothers were more likely to discontinue breast-feeding (62%) and introduce solids early (37%) than most other ethnic minority groups; those stopping before 4 months were more likely to introduce solids early compared with those continuing to breastfeed beyond this age (adjusted rate ratio (95% confidence interval): 1.3 (1.1 -1.2)). Educated mothers were less likely to stop breast-feeding before 4 months (white mothers, 0.8 (0.8-0.9); non-white mothers, 0.9 (0.8 -1.0)) than those with no/minimal qualifications but, among ethnic minorities, were more likely to introduce solids early (1.3 (1.0 -1.6)). Socio-economic status was positively associated with breast-feeding continuation among white women, and with age at introduction of solids among nonwhite women. Conclusions: We have identified important geographic, ethnic and social inequalities in breast-feeding continuation and introduction of solids within the UK, many of which have not been reported previously. The factors mediating these associations are complex and merit further study to ensure that interventions proposed to promote maternal adherence to current infant feeding recommendations are appropriate and effective.

Section: Resultsmentioning

confidence: 99%

Do early infant feeding practices vary by maternal ethnic group?

Griffiths

Tate

Dezateux³

2007

“…The breadth of data on employment in the MCS allowed us to identify factors related to breast-feeding duration that have not been reported on previously, including reasons for returning to employment, work place arrangements and type of maternity leave pay. Although information on infant feeding was collected retrospectively at 9 months postpartum, maternal recall of breast-feeding has been shown to be reliable and valid 25 .…”

Section: Discussionmentioning

confidence: 99%

The impact of maternal employment on breast-feeding duration in the UK Millennium Cohort Study

Hawkins¹,

Griffiths²,

Dezateux³

et al. 2007

109

Objective: To examine the relationship of maternal employment characteristics, day care arrangements and the type of maternity leave pay to breast-feeding for at least 4 months. Design: Cohort study. Setting: Babies aged 9 months in the Millennium Cohort Study, born between September 2000 and January 2002. Subjects: A total of 6917 British/Irish white employed mothers with singleton babies. Results: Mothers employed part-time or self-employed were more likely to breast-feed for at least 4 months than those employed full-time (adjusted rate ratio (aRR) and 95% confidence interval (CI) 1.30 (1.17-1.44) and 1.74 (1.46-2.07), respectively). The longer a mother delayed her return to work postpartum, the more likely she was to breast-feed for at least 4 months (P for trend , 0.001). Mothers were less likely to breast-feed for at least 4 months if they returned to work for financial reasons (aRR 0.86, 95% CI 0.80-0.93) or used informal day care arrangements rather than care by themselves or their partner (aRR 0.81, 95% CI 0.71 -0.91). Mothers were more likely to breastfeed for at least 4 months if their employer offered family-friendly (aRR 1.14, 95% CI 1.02 -1.27) or flexible work arrangements (aRR 1.24, 95% CI 1.00-1.55), or they received Statutory Maternity Pay (SMP) plus additional pay during their maternity leave rather than SMP alone (aRR 1.13, 95% CI 1.02 -1.26). These findings were independent of confounding factors, such as socio-economic status and maternal education. Conclusions: Current policies may encourage mothers to enter or return to employment postpartum, but this may result in widening inequalities in breastfeeding and persistence of low rates. Policies should aim to increase financial support and incentives for employers to offer supportive work arrangements.

“…Li et al (32) concluded in their review that mothers seems to provide accurate estimates of initiation and duration of any breastfeeding, especially when the duration is recalled over a period of 3 years or less. The validity and reliability of maternal recall for the age at introduction of foods and fluids other than breast milk seems to be less satisfactory (32) . We used several questions to assess exclusive breast-feeding, breast-feeding and introduction of solid foods, but we cannot fully exclude recall bias.…”

Section: Introduction Of Solid Foodsmentioning

confidence: 99%

Factors associated with exclusive breast-feeding and breast-feeding in Norway

Kristiansen

Lande

Øverby

et al. 2010

115

Objective: To identify factors associated with exclusive breast-feeding and breastfeeding during the first year of life among Norwegian infants. Design: Data on breast-feeding practices were collected by a semi-quantitative FFQ. Setting: In 2006-2007 about 3000 infants were invited to participate in a populationbased prospective cohort study in Norway. Subjects: A total of 1490 mothers/infants participated at both 6 and 12 months of age. Results: Exclusive breast-feeding at 4 months was associated with parental education, parity and geographical region, while exclusive breast-feeding at 5?5 months was associated only with maternal age. At both ages, a negative association with exclusive breast-feeding was observed for maternal smoking. Breast-feeding at 6 months was associated with parental education, maternal age and marital status. Breast-feeding at 12 months was associated with maternal education, maternal age and number of children. At both ages, negative associations with breast-feeding were observed for maternal smoking and descending birth weight. At 12 months, a negative association was also observed for having day care by other than the parents. Conclusions: Even though Norway has an extensive and positive breast-feeding tradition and a maternal leave system that supports the possibility to breast-feed, factors like maternal education, maternal age and maternal smoking are strongly associated with duration of exclusive breast-feeding and breast-feeding. Research to better understand the reasons for inequalities in breast-feeding is needed to facilitate the development of more effective breast-feeding promotion strategies. This again may improve compliance with recommendations and reduce inequalities in infant feeding practices.Keywords Exclusive breast-feeding Breast-feeding Infant feeding practices Adequate nutrition during infancy and early childhood is essential to ensure growth, health and development of children to reach their full potential. Breast milk strongly contributes to good health and nutrition of infants. Apart from being an excellent nutritional source for the growing child, breast milk is associated with a reduced risk of many diseases in infants and mothers. A recent review by Duijts et al. (1) points out that a number of studies in industrialised countries suggest that breast-feeding protects infants against overall infections, gastrointestinal and respiratory tract infections. Moreover, Ip et al. (2) reported long-term benefits of breast-feeding for infants to be reduced risk of obesity and type 2 diabetes in later life, and long-term benefits for breast-feeding mothers to be reduced risk of breast and ovarian cancers.The initiation and duration of exclusive breast-feeding and breast-feeding are influenced by a number of factors. Although the factors that influence the initiation and duration of breast-feeding in developed countries have been broadly studied (3)(4)(5) , previous studies in these countries have rarely examined the factors associated with exclusive breast-feedi...