Factors associated with breastfeeding: analysis of area-based data and a women's survey

Summary

Babies who are not breastfed have poorer health in infancy and childhood. One of the Public Service Agreement indicators was to increase the breastfeeding rates at 6-8 weeks. Breastfeeding promotion and support is an important component of local and national health service delivery.

The aim of this study was to measure the effects of breastfeeding interventions and socio-demographic factors on area-based breastfeeding rates. The specific objectives were to:

1. Collate area-based data on breastfeeding prevalence at 6-8 weeks, socio-demographic factors and breastfeeding interventions
2. Use these data to identify predictors of variation between areas in breastfeeding prevalence at 6-8 weeks
3. Use individual level data to measure the demand for breastfeeding services
4. Monitor changes over time in breastfeeding prevalence.

Area-based data on breastfeeding rates at 6-8 weeks and socio-demographic factors (e.g. maternal age, ethnicity, deprivation) are routinely available. These data were linked to information on hospital and community Baby Friendly accreditation. Regression models were used to identify socio-demographic predictors of area variation in breastfeeding at birth and 6-8 weeks. The demand for breastfeeding services was assessed using data from the 2010 National Maternity Survey. An analysis focusing on women initiating breastfeeding investigated socio-demographic and support factors associated with breastfeeding cessation in the first 6 weeks.

Key findings

• There are striking associations between socio-demographic factors and breastfeeding at the area level, with much of the heterogeneity in breastfeeding rates between areas explained by socio-demographic profile.
• Interventions designed to increase breastfeeding need to be tailored to the local socio-demographic context, and monitoring and assessment of area-based breastfeeding rates should take this into account.
• Analysis of the 2010 National Maternity Survey suggests that although socio-demographic factors are strongly assocated with breastfeeding continuation, there is evidence that breastfeeding support, including that delivered by peer or lay support workers, may have an important role in preventing cessations in the first few weeks.

Publications

Journal Articles

• Oakley LL, Renfrew MJ, Kurinczuk JJ, Quigley MA. Factors associated with breastfeeding in England: an analysis by primary care trust. BMJ open. 2013;3(6):e002765.
• Oakley LL, Henderson J, Redshaw M, Quigley MA. The role of support and other factors in early breastfeeding cessation: an analysis of data from a maternity survey in England. BMC Pregnancy Childbirth. 2014;14(1):88.
• Oakley LL, Kurinczuk JJ, Renfrew MJ, Quigley MA. Breastfeeding in England: time trends 2005-2006 to 2012-2013 and inequalities by area profile. Maternal & child nutrition. 2016;12(3):440?51.
• Rayfield S, Oakley L, Quigley MA. Association between breastfeeding support and breastfeeding rates in the UK: a comparison of late preterm and term infants. BMJ open. 2015;5(11):e009144.