title: The contribution of parental and community ethnicity to breastfeeding practices: evidence from the Millennium Cohort Study.
abstract: BACKGROUND
  The association of ethnic and social factors at the individual and community level with inequalities in starting, and continuing, to breastfeed remains unclear. We explored these factors using data from the Millennium Cohort Study.
  
  
  METHODS
  We obtained data for 11 286 natural mothers [8207 (85%) white] of singleton infants, living in England at age 9 months. Breastfeeding mothers were defined as the proportion of all mothers who reported: putting their baby to the breast at least once and giving any breastmilk (initiation); and having started, continuing for at least 1 month (continuation).
  
  
  RESULTS
  In England, 72% of all mothers started breastfeeding, and of these 70% continued for at least 1 month. White mothers were the least likely to start breastfeeding (70%), as were multiparous mothers (69%), younger mothers, those with no academic qualifications (51%), in routine occupations (59%), or living in disadvantaged communities (60%). For white mothers, having a partner of a different ethnic group was independently and positively associated with breastfeeding initiation and continuation to 1 month [adjusted rate ratios (95% CI): 1.14 (1.07-1.21) and 1.09 (1.03-1.16), respectively]. White lone mothers were more likely to initiate breastfeeding if they lived in high ethnic minority communities [adjusted rate ratio (95% CI): 1.42 (1.15-1.76)] rather than disadvantaged areas. For all mothers, maternal age at first motherhood was positively associated with breastfeeding [adjusted rate ratio (95% CI): 1.06 (1.04-1.08) per 5 year increase].
  
  
  CONCLUSIONS
  Significant inequalities in breastfeeding practices remain within the UK. White women are less likely to breastfeed and, for these women, partner and community ethnicity have an important relation to starting and continuing to breastfeed. Our findings suggest that public health strategies to increase breastfeeding need to be focussed on mothers who are young at first motherhood and address support offered by partners and the communities in which women live. Measures to evaluate the effectiveness of these strategies over time and between places should take account of changes in ethnic composition of the child-bearing population.
authors.affiliation: Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. l.griffiths@ich.ucl.ac.uk
authors.forename: Lucy J
authors.initials: LJ
authors.lastname: Griffiths
authors.forename: A Rosemary
authors.initials: AR
authors.lastname: Tate
authors.forename: Carol
authors.initials: C
authors.lastname: Dezateux
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000208:ethnology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D008423:Maternal Age; D010298:Parity; D011204:Poverty Areas; D011247:Pregnancy; D012959:Socioeconomic Factors; D018454:Spouses / Q000208:ethnology; D006113:United Kingdom / Q000453:epidemiology