Education, ethnicity and breastfeeding

The Generation R Study is a population-based prospective cohort study from fetal life until young adulthood. The study focuses on 4 primary areas of research: growth and physical development; behavioural and cognitive development; diseases in childhood; and health and healthcare for pregnant women and children. In total almost 10,000 mothers with a delivery date from April 2002 until January 2006 were enrolled in the study. Sub-studies looked at breastfeeding. Exclusive breastfeeding until the age of 4 months and partially thereafter was associated with a significant reduction of respiratory and gastrointestinal morbidity in infants. These findings support health-policy strategies to promote exclusive breastfeeding for at least 4 months, but preferably 6 months, in industrialized countries. These goals however were not reached by the research subjects (mothers and children from all over Rotterdam from all backgrounds and classes). Especially the most vulnerable children, those with lowest-educated mothers, were less likely to start breastfeeding (73% compared to (95% for those with highest-educated mothers) and for shorter duration (15% breastfed up to 6 months, compared to almost 40% for highest educated mothers).  Also ethnicity is a determining factor for breastfeeding initiation and continuation. More non-native mothers started breastfeeding than native mothers, but relative fewer continued. In both native Dutch and non-native mothers breastfeeding continuation rates are low.
van Rossem L, Oenema A, Steegers EAP, Moll HA, Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Are Starting and Continuing Breastfeeding Related to Educational Background? The Generation R Study. Pediatrics 2009 123: e1017-e1027
Jaddoe VWV, Hofman A, Mackenbach JP, Raat H: Breastfeeding patterns among ethnic minorities: the Generation R Study. J Epidemiol Community Health jech.2009.Published Online First: 8 December 2009
Duijts L, Jaddoe VWV, Hofman A, Moll HA: Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy. Pediatrics 2010 126: e18-e25