The relationship between breastfeeding and maternal education and family income

Abstract

Aim. To assess the relationship between breastfeeding and maternal education and family income in Samara.

Methods. A survey was conducted among 174 mothers in the children's outpatient clinic, in which their children were assigned at the place of residence. Information on breastfeeding and its duration, mother's education, and family income were obtained by questionnaire and copying data from outpatient records. Pearson's chi-square, Mann–Whitney U test and logistic regression were used in the statistical processing of the data.

Results. There was a positive association of maternal education (χ2=11.25; p=0.024) and income (χ2=11.5; p=0.022) with breastfeeding practices. Higher education, compared with specialized secondary or secondary education, increased the likelihood of breastfeeding for more than 6 months with an odds ratio of 2.6 (95% confidence interval 1.18–5.73; p=0.018). The median (and its Q1–Q3 quartiles) breastfeeding duration was 4.0 months (Q1–Q3 2.0–14.0 months) for mothers with secondary or specialized secondary education and 12.0 months (Q1–Q3 4.0–18.0 months; p=0.012) for mothers with higher education. It was found that 67.7% of women with incomes above the subsistence level per family member ($150) breastfed for more than 7 months and only 43.9% of women with incomes below the subsistence level (p=0.011). The likelihood of breastfeeding for more than 6 months in household income above one minimum wage per family member compared with household income below increases with an odds ratio of 2.18 (95% confidence interval 1.03–4.60; p=0.041). There was no relationship between lactation cessation and maternal education or family income.

Conclusion. There is a positive relationship between mother's education and family income and the practice of breastfeeding.

Keywords

breastfeeding / lactation / income / education level / socioeconomic status

References

[1] Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018. Implementation guidance. World Health Organization, UNICEF. https://apps.who.int/iris/bitstream/handle/10665/272943/9789241513807-eng.pdf?ua=1 (access date: 24.12.2020).

[2] Natsional'naya programma optimizatsii vskarmlivaniya detey pervogo goda zhizni v Rossiyskoy Federatsii. (The national program of optimization of feeding of children of the first year of life in the Russian Federation.) Approved at the XVI Congress of Pediatricians of Russia. February 2009. Moscow. 2010; 68 p. https://mosgorzdrav.ru/uploads/imperavi/ru-RU/%D0%9D%D0%90%D0%A6%D0%98%D0%9E%D0%9D%D0%90%D0%9B%D0%AC%D0%9D%D0%90%D0%AF%20%D0%9F%D0%A0%D0%9E%D0%93%D0%A0%D0%90%D0%9C%D0%9C%D0%90%20%D0%9E%D0%9F%D0%A2%D0%98%D0%9C%D0%98%D0%97%D0%90%D0%A6%D0%98%D0%98%20%D0%92%D0%A1%D0%9A%D0%90%D0%A0%D0%9C%D0%9B%D0%98%D0%92%D0%90%D0%9D%D0%98%D0%AF%20%D0%94%D0%95%D0%A2%D0%95%D0%99%20%D0%9F%D0%95%D0%A0%D0%92%D0%9E%D0%93%D0%9E%20%D0%93%D0%9E%D0%94%D0%90%20%D0%96%D0%98%D0%97%D0%9D%D0%98%20%D0%92%20%D0%A0%D0%9E%D0%A1%D0%A1%D0%98%D0%99%D0%A1%D0%9A%D0%9E%D0%99%20%D0%A4%D0%95%D0%94%D0%95%D0%A0%D0%90%D0%A6%D0%98%D0%98.pdf (access date: 24.12.2020) (In Russ.)

[3] Национальная программа оптимизации вскармливания детей первого года жизни в Российской Федерации. Утверждена на XVI съезде педиатров России (февраль 2009 г.). Москва. 2010; 68 с. https://mosgorzdrav.ru/uploads/imperavi/ru-RU/НАЦИОНАЛЬНАЯ%20ПРОГРАММА%20ОПТИМИЗАЦИИ%20ВСКАРМЛИВАНИЯ%20ДЕТЕЙ%20ПЕРВОГО%20ГОДА%20ЖИЗНИ%20В%20РОССИЙСКОЙ%20ФЕДЕРАЦИИ.pdf (дата обращения: 24.12.2020).

[4] Vandenplas Y. Oligosaccharides in infant formula. Br. J. Nutr. 2002; 87 (2): S293–S296. DOI: 10.1079/BJNBJN/2002551.

[5] Sovremennye rekomendatsii po pitaniyu detey. (Modern recommendations for children's nutrition.) Ed. by Yu.G. Mukhina, I.Ya. Kon`. M.: Medpraktika-M. 2010; 568 p. (In Russ.)

[6] Современные рекомендации по питанию детей. Под ред. Ю.Г. Мухиной, И.Я. Коня. М.: Медпрактика-М. 2010; 568 с.

[7] Netrebenko O.K. Nutrition and growth of the infant: long-term consequences and the connection with diseases. Pediatriya. 2009; 88 (5): 72–76. (In Russ.)

[8] Нетребенко О.К. Питание и рост грудного ребёнка: отдалённые последствия и связь с заболеваниями. Педиатрия. 2009; 88 (5): 72–76.

[9] Speranskiy G.N. Rebenok rannego vozrasta. (Child of early age.) M.-L.: Medgiz. 1940; 120 p. (In Russ.)

[10] Сперанский Г.Н. Ребёнок раннего возраста. М.-Л.: Медгиз. 1940; 120 с.

[11] Rukovodstvo po detskomu pitaniyu. (Child Nutrition Guide.) Ed. by V.A. Tutel'yan, I.Ya. Kon`. M.: MIA. 2004; 662 p. (In Russ.)

[12] Руководство по детскому питанию. Под ред. В.А. Тутельяна, И.Я. Коня. М.: МИА. 2004; 662 с.

[13] Hawkins S.S., Stern A.D., Baum C.F., Gillman M.W. Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis. Public Health Nutr. 2015; 18 (2): 189–197. DOI: 10.1017/S1368980014000238.

[14] Meyrose A.K., Klasen F., Otto C., Gniewosz G., Lampert T., Ravens-Sieberer U. Benefits of maternal edu­cation for mental health trajectories across childhood and ­adolescence. Soc. Sci. Med. 2018; 202: 170–178. DOI: 10.1016/j.socscimed.2018.02.026.

[15] Güneş P.M. The role of maternal education in child health: evidence from a compulsory schooling law. Econom. Educ. Rev. 2015; 47: 1–16. DOI: 10.1016/j.econedurev.2015.02.008.

[16] Wallby T., Hjern A. Region of birth, income and breastfeeding in a Swedish county. Acta Paediatr. 2009; 98: 1799–1804. DOI: 10.1111/j.1651-2227.2009.01455.x.

[17] Cattaneo A. Academy of breastfeeding medicine founder's lecture 2011: inequalities and inequities in breastfeeding: an international perspective. Breastfeed Med. 2012; 7 (1): 3–9. DOI: 10.1089/bfm.2012.9999.

[18] Brown A.E., Raynor P., Benton D., Lee M.D. Indices of multiple deprivation predict breastfeeding duration in England and Wales. Eur. J. Public. Health. 2010; 20 (2): 231–235. DOI: 10.1093/eurpub/ckp114.

[19] Ibanez G., de Reynal de Saint Michel C., Denan­tes M., Saurel-Cubizolles M.J., Ringa V., Magnier A.M. Systematic review and meta-analysis of randomized controlled trials evaluating primary care-based interventions to promote breastfeeding in low-income women. Fam. Pract. 2012; 29 (3): 245–254. DOI: 10.1093/fampra/cmr085.

[20] Acharya P., Khanal V. The effect of mother’s educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys. BMC Public Health. 2015; 15: 1069. DOI: 10.1186/s12889-015-2405-y.

[21] Heck K.E., Braveman P., Cubbin C., Chávez G.F., Kiely J.L. Socioeconomic status and breastfeeding initiation among California mothers. Public Health Rep. 2006; 121 (1): 51–59. DOI: 10.1177/003335490612100111.

[22] Skafida V. The relative importance of social class and maternal education for breast-feeding initiation. Public Health Nutr. 2009; 12: 2285–2292. DOI: 10.1017/S1368980009004947.

[23] Busck-Rasmussen M., Villadsen S.F., Norsker F.N., Mortensen L., Andersen A.M. Breastfeeding practices in relation to country of origin among women living in Denmark: a population-based study. Matern. Child Health J. 2014; 18 (10): 2479–2488. DOI: 10.1007/s10995-014-1486-z.

[24] Baerug A., Laake P., Løland B.F., Tylleskär T., Tufte E., Fretheim A. Explaining socioeconomic inequalities in exclusive breast feeding in Norway. Arch. Dis. Child. 2017; 102 (8): 708–714. DOI: 10.1136/archdischild-2016-312038.

[25] Levinienė G., Tamulevičienė E., Kudzytė J., Petra­uskienė A., Zaborskis A., Aželienė I., Labanauskas L. Factors associated with breastfeeding duration. ­Medicina (Kaunas). 2013; 49 (9): 415–421. DOI: 10.3390/medicina49090065.

[26] Kooijman M.N., Kruithof C.J., van Duijn C.M., Du­ijts L., Franco O.H., van Jzendoorn M.H., de Jongste J.C., Klaver C.C., van der Lugt A., Mackenbach J.P., Moll H.A., Pee­ters R.P., Raat H., Rings E.H., Rivadeneira F., van der Schroeff M.P., Steegers E.A., Tiemeier H., Uitterlinden A.G., Ver­hulst F.C., Wolvius E., Felix J.F., Jaddoe V.W. The Gene­ration R Study: design and cohort update 2017. Eur. J. Epidemiol. 2016; 31 (12): 1243–1264. DOI: 10.1007/s10654-016-0224-9.

[27] Alemayehu T., Haidar J., Habte D. Determinants of exclusive breastfeeding practices in Ethiopia. Ethiopian J. Health Develop. 2009; 23 (1): 12–18. DOI: 10.4314/ejhd.v23i1.44832.

[28] Mihrshahi S., Kabir I., Roy S.K., Agho K.E., Sena­rath U., Dibley M.J., South Asia Infant Feeding Research Network. Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004. Food Nutr. Bulln. 2010; 31 (2): 295–313. DOI: 10.1177/156482651003100220.

[29] Robertson A. Breastfeeding initiation at birth can help reduce health inequalities. Entre Nous. 2015; (81): 21–22.

[30] Hoffmann R., Eikemo T.A., Kulhánová I., Kulik M.C., Looman C., Menvielle G., Deboosere P., Martikainen P., Regidor E., Mackenbach J.P. Obesity and the potential reduction of social inequalities in mortality: evidence from 21 European populations. Eur. J. Public Health. 2015; 25: 849–856. DOI: 10.1093/eurpub/ckv090.

[31] Decree of the Government of the Samara Region No. 533 issued at 06.08.2019 “On establishing the ­value of the subsistence minimum in the Samara Region for the II quarter of 2019 per capita and for the main socio-­demographic groups”. https://pravo.samregion.ru/wp-­content/uploads/sites/2/2019/08/0608_533.pdf (access date: 17.03.2021). (In Russ.)

[32] Постановление Правительства Самарской области от 06.08.2019 №533 «Об установлении величины прожиточного минимума в Самарской области за II квартал 2019 года в расчёте на душу населения и по основным социально-демографическим группам». https://pravo.samregion.ru/wp-content/uploads/sites/2/2019/08/0608_533.pdf (дата обращения: 17.03.2021).

[33] Victora C.G., Bahl R., Barros A.J., França G.V., Horton S., Krasevec J., Murch S., Sankar M.J., Walker N., Rollins N.C.; Lancet Breastfeeding Series Group. Breastfee­ding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387: 475–490. DOI: 10.1016/S0140-6736(15)01024-7.

[34] Capture the moment. Early initiation of breastfee­ding: The best start for every newborn. New York: UNICEF. 2018. https://www.unicef.org/publications/files/UNICEF_WHO_Capture _the_moment_EIBF_2018.pdf (access date: 24.12.2020).

RIGHTS & PERMISSIONS

Bezrukova A.A., Yarmolinskaya M.I., Sazonova O.V., Spiridonova N.V., Komarova M.N.