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 Pediatricians recommend that infants be exclusively breastfed until
at least 6 months of age because it can reduce their risk of ear and
respiratory infections, sudden infant death syndrome, allergies,
childhood obesity and diabetes.
Researchers followed two groups of mothers who gave birth in Germany
about a decade apart and found that, over time, women became more
likely to continue breastfeeding for 4 to 6 months. But these gains
were limited to more educated women.
Among less educated mothers, the researchers only saw gains in
breastfeeding after accounting for several factors that can get in
the way of nursing babies, including a ceasarean delivery or
smoking.
“Lower educated women were less likely to overcome these barriers as
easily as those with higher education,” said study co-author Dr.
Dietrich Rothenbacher of Ulm University in Germany.
“If these barriers did not exist, we would have observed a similar
improvement in breastfeeding patterns in the lower educated strata”
Rothenbacher added by email.
As reported in Pediatrics, Rothenbacher and colleagues analyzed data
from one maternity ward for 989 women who gave birth in 2000-2001
and 856 women who had babies in 2012-2013.
Compared to the earlier group, women in the later group were 21
percent less likely to have stopped predominantly breastfeeding by 4
months and 29 percent less likely to have stopped total
breastfeeding by 6 months.
Women with less than 12 years of education had fewer gains in
breastfeeding over time, however. By the end of the study period,
women with less education were just 8 percent less likely to stop
predominantly breastfeeding by 4 months, compared with 24 percent
lower odds for women with more education.
One limitation of the study is that researchers lacked data on
family attitudes about breastfeeding and any medical conditions that
might have influenced how long women nursed, the authors note.
The disparities might look different in the U.S., where a lack of
paid family medical leave and differences in access to flexible work
schedules might leave poor women with less support for breastfeeding
than more affluent mothers, said Jennifer Pitonyak, a researcher at
the University of Washington in Seattle who wasn’t involved in the
study.
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“Continuing to breastfeed an infant is challenging when there is a
lack of support – particularly for women with lower levels of
education and income who may need to return to work as soon as
possible after giving birth in order to financially support their
family,” Pitonyak said by email.
Shifts in public policy or social norms in Germany also might not
mirror what’s happened in other countries, noted Ruth Newby, a
researcher at the University of the Sunshine Coast in Queensland,
Australia, who wasn’t involved in the study.
What happened in Germany “might be due to shifts in the German
economy or in government policy with impacts on things like family
income and women’s work,” Newby said by email.
At the same time, a growing body of research suggests that women’s
self-confidence and determination may also play a role in
neutralizing some of the negative impact of financial or social
pressures that deter women from breastfeeding, said Melanie
Lutenbacher, a researcher at the Vanderbilt University School of
Nursing in Nashville who wasn’t involved in the study.
“The take-home message for women if they’re thinking about
breastfeeding is do your homework,” Lutenbacher said by email. “At
this point, the burden is still really on the woman for
breastfeeding to be successful. She needs to build a breastfeeding
support system while still pregnant, identify people from her family
and friend circle who are supportive, and learn as much as she can
about breastfeeding.”
SOURCE: http://bit.ly/1SRkvXA Pediatrics, online April 19, 2016.
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