title: Explaining socioeconomic inequalities in exclusive breast feeding in Norway.
abstract: In high-income countries, lower socioeconomic position is associated with lower rates of breast feeding, but it is unclear what factors explain this inequality. Our objective was to examine the association between socioeconomic position and exclusive breast feeding, and to explore whether socioeconomic inequality in exclusive breast feeding could be explained by other sociodemographic characteristics, for example, maternal age and parity, smoking habits, birth characteristics, quality of counselling and breastfeeding difficulties.
  
  
  
  We used data from a questionnaire sent to mothers when their infants were five completed months as part of a trial of a breastfeeding intervention in Norway. We used maternal education as an indicator of socioeconomic position. Analyses of 1598 mother-infant pairs were conducted using logistic regression to assess explanatory factors of educational inequalities in breast feeding.
  
  
  
  Socioeconomic inequalities in exclusive breast feeding were present from the beginning and persisted for five completed months, when 22% of the most educated mothers exclusively breast fed compared with 7% of the least educated mothers: OR 3.39 (95% CI 1.74 to 6.61). After adjustment for all potentially explanatory factors, the OR was reduced to 1.49 (95% CI 0.70 to 3.14). This decrease in educational inequality seemed to be mainly driven by sociodemographic factors, smoking habits and breastfeeding difficulties, in particular perceived milk insufficiency.
  
  
  
  Socioeconomic inequalities in exclusive breast feeding at 5 months were largely explained by sociodemographic factors, but also by modifiable factors, such as smoking habits and breastfeeding difficulties, which can be amenable to public health interventions.
  
  
  
  NCT01025362.
authors.affiliation: Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
authors.forename: Anne
authors.initials: A
authors.lastname: Bærug
authors.affiliation: Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway.
authors.forename: Petter
authors.initials: P
authors.lastname: Laake
authors.affiliation: Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
authors.forename: Beate Fossum
authors.initials: BF
authors.lastname: Løland
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Thorkild
authors.initials: T
authors.lastname: Tylleskär
authors.affiliation: Norwegian National Advisory Unit on Breastfeeding, Women and Children's Division, Oslo University Hospital, Oslo, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Tufte
authors.affiliation: Knowledge Centre for the Health Services, Norwegian Institute of Public Health, Oslo, Norway.|Institute of Health and Society, University of Oslo, Oslo, Norway.
authors.forename: Atle
authors.initials: A
authors.lastname: Fretheim
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001942:Breast Feeding / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D017533:Marital Status; D008423:Maternal Age; D009664:Norway / Q000453:epidemiology; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
keywords: Infant Feeding; breastfeeding; socioeconomic inequality