Breast-feeding in a UK urban context: who breast-feeds, for how long and does it matter?
OBJECTIVE
To investigate what factors relate most strongly to breast-feeding duration in order to successfully support breast-feeding mothers.


METHODS
Prospective birth cohort study using questionnaires, routinely collected weights and health check at age 13 months.


METHODS
Gateshead, UK.


METHODS
Parents of 923 term infants born in a defined geographical area and recruited shortly after birth, 50% of whom were breast-feeding initially.


RESULTS
Only 225 (24%) infants were still breast-fed at 6 weeks, although 136 (15%) continued beyond 4 months. Infants in the most affluent quintile were three times more likely to be initially breast-fed (P < 0.001) and five times more likely to still be feeding at 4 months (P = 0.001) compared with infants in the most deprived quintile. A third of breast-fed infants were given supplementary feeds in the maternity unit and this was associated with a 10-fold increase in odds of giving up breast-feeding by discharge (P = 0.001). Frequent feeding was reported as a reason for giving up in 70% of mothers at 6 weeks and 55% at 4 months. Those infants who stopped breast-feeding earliest showed the most rapid weight gain and were tallest at age 13 months. Non-breast-fed infants had 50% more family doctor contacts up to age 4 months (P = 0.005).


CONCLUSIONS
Initiation of breast-feeding in urban Britain remains strongly determined by socio-economic background and early cessation seems to be related to frequent feeding and rapid growth as well as a continuing failure to eradicate health practices that undermine breast-feeding. Those infants not receiving breast milk suffered increased morbidity, but the apparent association between breast-feeding duration and growth probably reflects reverse causation.
Wright
Charlotte M
CM
Department of Child Health, Newcastle University, Newcastle upon Tyne, UK. charlotte.wright@clinmed.gla.ac.uk
Parkinson
Kathryn
K
Scott
Jane
J
D000328:Adult; D001903:Bottle Feeding / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn / Q000254:growth & development*; D008297:Male; D009035:Mothers / Q000523:psychology*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population; D015430:Weight Gain / Q000502:physiology