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Childcare use and inequalities in breastfeeding: findings from the UK Millennium Cohort Study

A Pearce1, L Li, J Abbas

  • 1Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, London, UK. a.pearce@ich.ucl.ac.uk

Archives of Disease in Childhood
|June 10, 2010
PubMed

Insights

Informal childcare, such as care by relatives, significantly reduces breastfeeding duration for all mothers. Formal childcare, like nurseries, also lowers breastfeeding rates, particularly for advantaged mothers using it full-time.

Area of Science:

  • Public Health
  • Maternal and Child Health
  • Socioeconomic Determinants of Health

Background:

  • UK breastfeeding initiation and duration rates are suboptimal and exhibit socioeconomic disparities.
  • Childcare settings represent a potential avenue for breastfeeding support and promotion.
  • Limited understanding exists regarding the influence of different childcare types on breastfeeding practices across socioeconomic strata.

Purpose of the Study:

  • To investigate the association between informal and formal childcare arrangements and the likelihood of breastfeeding for at least four months in a UK infant cohort.
  • To examine how these associations vary by socioeconomic status.

Main Methods:

  • Analysis of data from 18,050 infants in a contemporary UK cohort.
  • Calculation of relative risks (RR) for breastfeeding duration based on type (informal vs. formal) and intensity (part-time vs. full-time) of childcare commencing before four months of age.
  • Comparison group: infants cared for only by a parent (less than 10 hours/week childcare).

Main Results:

  • Informal childcare (care by friends, relatives) was associated with a reduced likelihood of breastfeeding (RR 0.51).
  • Formal childcare (nurseries, crèches) was also associated with reduced breastfeeding likelihood (RR 0.84), especially when used full-time.
  • The negative association of informal childcare was consistent across socioeconomic groups. Formal childcare's negative impact was observed in more advantaged mothers (degree holders, managerial/professional backgrounds, couple families), while lone mothers showed an increased likelihood of breastfeeding with formal care (RR 1.65).

Conclusions:

  • Informal childcare arrangements are linked to decreased breastfeeding duration across all maternal socioeconomic groups.
  • Formal childcare, particularly full-time use, is associated with reduced breastfeeding likelihood, primarily among mothers from more advantaged backgrounds.
  • Lone mothers utilizing formal childcare demonstrated a higher likelihood of breastfeeding, suggesting complex interactions between childcare type, intensity, and maternal circumstances.
Abstract

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