No widening socioeconomic gap within a general decline in Swedish breastfeeding
M Magnusson1,2, D Lagerberg1, T Wallby1,2
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Insights
Swedish breastfeeding rates declined, but socioeconomic gaps did not widen. Instead, the gap narrowed between mothers with different educational levels and family types over time.
Area of Science:
- Public Health
- Sociology
- Pediatrics
Background:
- Breastfeeding rates in Sweden have shown a gradual decline since the late 1990s.
- Understanding socioeconomic disparities in breastfeeding is crucial for public health initiatives.
Purpose of the Study:
- To investigate potential socioeconomic differences within the observed decline in breastfeeding rates in Sweden.
- To determine if socioeconomic gaps in breastfeeding widened or narrowed over time.
Main Methods:
- Analysis of data from 51,415 infants born between 2004-2010 in Uppsala and Orebro counties, Sweden.
- Utilized breastfeeding data at 1 week, 4 months, and 6 months, linked with national socioeconomic indicators.
- Employed logistic regression models with generalized estimating equations (GEE) to analyze trends and socioeconomic factors.
Main Results:
- While overall breastfeeding rates declined, socioeconomic status influenced rates in a gradient manner.
- No widening of the socioeconomic gap in breastfeeding was detected; instead, a narrowing gap was observed.
- Specifically, a narrowing gap was noted between mothers with high versus low educational levels and single versus cohabiting mothers at 4 and 6 months.
Conclusions:
- The study found no increase in the socioeconomic gap accompanying the general decline in Swedish breastfeeding.
- Continued and strengthened breastfeeding support measures are recommended, with particular attention to vulnerable groups.
Aim:
To study potential socioeconomic differences within the general decline in breastfeeding over time.
Methods:
Data was collected for 51 415 infants born 2004-2010 from the databases of statistics of the Preventive Child Health Care Services in Uppsala and Orebro counties in Sweden and socioeconomic indicators from Swedish national registers. Breastfeeding data (breastfed/not breastfed) from 1 week, 4 months and 6 months of age were used as the main outcome variables. Educational level of the mother was defined as the highest level on a three-grade scale, low, medium and high. Family type was defined as whether the mother was single or married/cohabiting. Family disposable income was divided into quartiles where quartile 1 included the 25% children in families with the lowest incomes. Analyses were conducted by logistic regression models using the methodology of generalized estimating equations (GEE). An exchangeable correlation structure was used to control for the dependence among infants with the same mother.
Results:
Breastfeeding rate in Sweden has declined gradually since the late 1990s. The results indicated that overall breastfeeding rates over the study period were influenced by socioeconomic status in a gradient manner but no widening socioeconomic gap was detected. Rather the interaction analyses showed a narrowing socioeconomic gap over the study period between high and low educational level and single versus cohabiting mothers at 4 months. The narrowing socioeconomic gap between the educational level categories was also detectable at 6 months.
Conclusion:
No increase in socioeconomic gap was detected within the general decline in Swedish breastfeeding. However, there are reasons to maintain and strengthen the overall breastfeeding supportive measures including extended support for vulnerable groups.
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