a1 Department of Child Health, Glasgow University, PEACH Unit, QMH Tower, Yorkhill Hospitals, Glasgow G3 8SJ, UK
a2 Department of Child Health, Newcastle University, Newcastle upon Tyne, UK
a3 Department of Human Nutrition, Glasgow University, Glasgow, UK
Objective To investigate what factors relate most strongly to breast-feeding duration in order to successfully support breast-feeding mothers.
Design Prospective birth cohort study using questionnaires, routinely collected weights and health check at age 13 months.
Setting Gateshead, UK.
Subjects 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.
(Received February 24 2005)
(Accepted October 26 2005)