Background
Methods
The data
Maternal socio-demographic and obstetric factors
| Borough of residence |
Ethnicity | |
Marital status | |
Parity | |
Mode of delivery | |
Socio-economic deprivation as measured by the Index of Multiple Deprivation scores. | |
Infant feeding practices in hospital
| The timing of breastfeeding initiation after delivery Infant formula-feeding status in hospital Teat-giving status in hospital |
Outcomes
Statistical analyses
Results
Maternal socio-demographic and obstetric characteristics and in-hospital infant feeding practices
Variable | Total No (%) | BwD No (%) | Hyndburn No (%) | P value |
---|---|---|---|---|
Borough of residence | ||||
Both | 2,107 (100%) | 1,606 (76.2%) | 501 (23.8%) | - |
BwD | 1,606 | 1,606 | - | - |
Hyndburn | 501 | - | 501 | - |
Ethnicity
| ||||
White | 1,003 (48.0%) | 622 (39.1%) | 381 (76.0%) | < 0.0001 |
Non-white | 1,088 (52.0%) | 968 (60.9%) | 120 (24.0%) | < 0.0001 |
▪ Indian | 496 (23.7%) | 489 (30.8%) | 7 (1.4%) | < 0.0001 |
▪ Pakistani | 503 (24.1%) | 403 (25.3%) | 100 (20.0%) | 0.0139 |
▪ All Blacks | 25 (1.2%) | 24 (1.5%) | 1 (0.2%) | 0.0097 |
▪ OthersΨ
| 64 (3.1%) | 52 (3.3%) | 12 (2.4%) | 0.3043 |
Total valid data | 2,091 (100.0%) | 1,590 (100.0%) | 501 (100.0%) | - |
Missing data | 16 | 16 | 0 | 0.0094 |
Marital status
| ||||
Mothers with partners | 2,030 (96.7%) | 1,551 (97.0%) | 479 (95.8%) | 0.1557 |
Single mothers | 69 (3.3%) | 48 (3.0%) | 21 (4.2%) | 0.1557 |
Total valid data | 2,099 (100.0%) | 1,599 (100.0%) | 500 (100.0%) | - |
Missing data | 8 | 7 | 1 | 0.4498 |
IMD quartile
| ||||
1st quartile | 542 (25.7%) | 362 (22.5%) | 180 (35.9%) | < 0.0001 |
2nd quartile | 516 (24.5%) | 360 (22.4%) | 156 (31.1%) | < 0.0001 |
3rd quartile | 526 (25.0%) | 477 (29.7%) | 49 (9.8%) | < 0.0001 |
4th quartile | 523 (24.8%) | 407 (25.3%) | 116 (23.2%) | 0.3221 |
Total valid data | 2,107 (100.0%) | 1,606 (100.0%) | 501(100.0%) | - |
Missing data | 0 | 0 | 0 | - |
Parity
| ||||
Primips | 897 (42.7%) | 675 (42.1%) | 222 (44.3%) | 0.1952 |
Multips | 1,206 (57.3%) | 927 (57.9%) | 279 (55.7%) | 0.1952 |
▪ 2nd births | 153 (7.3%) | 109 (6.8%) | 44 (8.8%) | 0.1358 |
▪ 3rd births | 521 (24.8%) | 392 (24.5%) | 129 (25.7%) | 0.5580 |
▪ 4th births | 296 (14.1%) | 242 (15.1%) | 54 (10.8%) | 0.0152◆
|
▪ 5th births | 155 (7.4%) | 125 (7.8%) | 30 (6.0%) | 0.1759 |
▪ 6th - 9th births | 82 (3.9%) | 60 (3.7%) | 22 (4.4%) | 0.5129 |
Total valid data | 2,103 (100.0%) | 1,602 (100.0%) | 501 (100.0%) | - |
Missing data | 4 | 4 | 0 | 0.3112 |
Mode of delivery
| ||||
Vaginal | 1,537 (73.3%) | 1,183 (74.1%) | 354 (70.8%) | 0.1333 |
Operative delivery | 560 (26.7%) | 414 (25.1%) | 146 (29.2%) | 0.1484 |
▪ Caesarean | 371 (17.7%) | 285 (17.8%) | 86 (17.2%) | 0.7377 |
▪ Instrumental | 189 (9.0%) | 129 (8.1%) | 60 (12.0%) | 0.0074 |
Total valid data | 2,097 (100.0%) | 1,597 (100.0%) | 500 (100.0%) | - |
Missing data | 10 | 9 | 1 | 0.2989 |
Variable | Total No (%) | BwD No (%) | Hyndburn No (%) | P value |
---|---|---|---|---|
Breastfeeding initiation | ||||
Within 1 hr | 1,609 (77.7%) | 1,212 (77.0%) | 397 (79.9%) | 0.1748 |
After 1 hr | 462 (22.3%) | 362 (23.0%) | 100 (20.1%) | |
▪ After 1 hr to 48 hrs | 419 (20.2%) | 329 (20.9%) | 90 (18.1%) | 0.1765 |
▪ After 48 hrs | 43 (2.1%) | 33 (2.1%) | 10 (2.0%) | > 0.9999 |
Total valid data | 2,071 (100.0%) | 1,574 (100.0%) | 497 (100.0%) | - |
Missing data | 36 | 32 | 4 | 0.0527 |
Formula in hospital
| ||||
No formula | 1,606 (76.5%) | 1,212 (75.8%) | 394 (78.8%) | 0.1652 |
Formula | 493 (23.5%) | 387 (24.2%) | 106 (21.2%) | 0.1652 |
▪ Yes (informed choice) | 209 (10.0%) | 151 (9.4%) | 58 (11.6%) | 0.1472 |
▪ Yes (medical indication) | 209 (10.0%) | 171 (10.7%) | 38 (7.6%) | 0.0404 |
▪ Yes (other reasons) | 75 (3.6%) | 65 (4.1%) | 10 (2.0%) | 0.0201 |
Total valid data | 2,099 (100.0%) | 1,599 (100.0%) | 500 (100.0%) | - |
Missing data | 8 | 7 | 1 | 0.4498 |
Teats in Hospital
| ||||
No teats | 1,766 (84.3%) | 1,349 (84.6%) | 417 (83.2%) | 0.4399 |
Yes | 329 (15.7%) | 245 (15.4%) | 84 (16.8%) | 0.4399 |
▪ Yes (informed choice) | 159 (7.6%) | 95 (6.0%) | 64 (12.8%) | < 0.0001 |
▪ Yes (other reasons) | 170 (8.1%) | 150 (9.4%) | 20 (4.0%) | < 0.0001 |
Total valid data | 2,095 (100.0%) | 1,594 (100.0%) | 501 (100.0%) | - |
Missing data | 12 | 12 | 0 | 0.0458 |
Infant feeding methods
Feeding methods | 6 weeks | 17 weeks | 6 months | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total No (%) | BwD No (%) | Hyndburn No (%) | PΔ value | Total No (%) | BwD No (%) | Hyndburn No (%) | PΔ value | Total No (%) | BwD No (%) | Hyndburn No (%) | PΔ value | |
Exclusively breast | 1,449 (69.2%) | 1,120 (70.3%) | 329 (65.8%) | 0.0594 | 930 (46.2%) | 740 (48.2%) | 190 (39.7%) | 0.0011 | 262 (13.4%) | 223 (14.9%) | 39 (8.5%) | 0.0002 |
Exclusively formula | 327 (15.6%) | 235 (14.7%) | 92 (18.4%) | 0.0484 | 414 (20.6%) | 299 (19.5%) | 115 (24.1%) | 0.0212 | 85 (4.3%) | 70 (4.7%) | 15 (3.3%) | 0.1941 |
Formula & Breast | 318 (15.2%) | 239 (15.0%) | 79 (15.8%) | 0.6183 | 258 (12.8%) | 200 (13.0%) | 58 (12.1%) | 0.5853 | 55 (2.8%) | 43 (2.9%) | 12 (2.6%) | 0.7511 |
Breast & solid#
| 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 53 (2.6%) | 38 (2.5%) | 15 (3.1%) | 0.3360 | 502 (25.6%) | 392 (26.2%) | 110 (23.9%) | 0.0233 |
Formula & solid#
| 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 4 (0.2%) | 4 (0.3%) | 0 (0.0%) | 0.3111 | 93 (4.7%) | 84 (5.6%) | 9 (2.0%) | 0.0004 |
Breast, formula & solid#
| 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 28 (1.4%) | 20 (1.3%) | 8 (1.7%) | 0.3905 | 179 (9.1%) | 130 (8.7%) | 49 (10.6%) | 0.1972 |
Solid#
| 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 2 (0.1%) | 2 (0.1%) | 0 (0.0%) | - |
Had stopped BF* | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - | 326 (16.2%) | 234 (15.2%) | 92 (19.2%) | 0.0336 | 781 (39.9%) | 554 (37.0%) | 227 (49.2%) | < 0.0001 |
Total valid data | 2,094 (100.0%) | 1,594 (100.0%) | 500 (100.0%) | - | 2,013 (100.0%) | 1,535 (100.0%) | 478 (100.0%) | - | 1,959 (100.0%) | 1,498 (100.0%) | 461 (100.0%) | - |
Missing data | 13 | 12 | 1 | 0.2081 | 94 | 71 | 23 | 0.8057 | 148 | 108 | 40 | 0.3188 |
Breastfeeding cessation
Effects of maternal socio-demographic and obstetric characteristics on breastfeeding cessation
Breastfeeding duration from KM analyses | Unadjusted Cox HR | Adjusted Cox HRΦ
| ||||
---|---|---|---|---|---|---|
Variable | Mean (95% CI) | Median (95% CI) | (95% CI) | P value | (95% CI) | P value |
Borough of residence
| ||||||
Both | 21.6 (20.86 to 22.37) | 27 (25.70 to 28.30) | - | - | - | - |
BwD | 22.5 (21.63 to 23.39) | 27 (26.11 to 27.88) | 1†
| - | - | - |
Hyndburn | 18.5 (17.36 to 19.73) | 22 (18.69 to 25.30) | 1.36 (1.18 to 1.55) | < 0.0001 | - | - |
Ethnicity
| - | - | ||||
White | 19.8 (18.53 to 20.97) | 20 (17.60 to 22.39) | 1†
| - | 1†
| - |
Non-white | 23.4 (22.42 to 24.34) | 27 (26.03 to 27.97) | 0.65 (0.57 to 0.73) | < 0.0001 | 0.59 (0.52 to 0.67) | <0.0001 |
▪ Indian | 24.8 (23.53 to 26.15) | 28 (26.67 to 29.33) | 0.55 (0.46 to 0.64) | < 0.0001 | 0.53 (0.45 to 0.62) | < 0.0001 |
▪ Pakistani | 21.8 (20.27 to 23.25) | 26 (25.05 to 26.95) | 0.79 (0.68 to 0.91) | 0.0015 | 0.69 (0.60 to 0.81) | < 0.0001 |
▪ All Blacks | 25.1 (20.79 to 29.51) | 28 (25.18 to 30.81) | 0.40 (0.19 to 0.84) | 0.0155 | 0.35 (0.16 to 0.74) | 0.0057 |
▪ OthersΨ
| 24.5 (20.11 to 28.81) | 27 (25.89 to 28.11) | 0.52 (0.35 to 0.78) | 0.0018 | 0.48 (0.32 to 0.73) | 0.0005 |
Marital status
| ||||||
Single mothers | 18.2 (15.19 to 21.17) | 24 (17.77 to 30.23) | 1†
| - | - | - |
Mothers with partners | 21.6 (20.89 to 22.35) | 27 (25.69 to 28.31) | 0.80 (0.58 to 1.11) | 0.1815 | - | - |
IMD quartile
| ||||||
1st quartile | 21.3 (19.69 to 22.82) | 25 (22.71 to 27.29) | 1†
| - | - | - |
2nd quartile | 20.9 (19.52 to 22.21) | 26 (23.36 to 28.64) | 1.01 (0.86 to 1.19) | 0.8873 | - | - |
3rd quartile | 23.2 (21.37 to 24.97) | 27 (26.21 to 27.79) | 0.78 (0.66 to 0.92) | 0.0043 | - | - |
4th quartile | 20.8 (19.66 to 21.96) | 27 (24.86 to 29.13) | 0.90 (0.76 to 1.06) | 0.2097 | - | - |
Parity
| ||||||
Primips | 20.4 (19.24 to 21.54) | 25 (23.19 to 26.81) | 1.25 (1.11 to 1.41) | 0.0003 | 1.23 (1.09 to 1.39) | 0.0007 |
Multips§
| 22.5 (21.54 to 23.50) | 27 (25.99 to 28.01) | 1†
| - | 1†
| - |
▪ 2nd births | 20.0 (16.71 to 23.35) | 18 (14.21 to21.79) | - | - | - | - |
▪ 3rd births | 22.4 (21.05 to 23.80) | 27 (26.12 to 27.88) | - | - | - | - |
▪ 4th births | 23.5 (21.55 to 25.36) | 27 (23.98 to 30.02) | - | - | - | - |
▪ 5th births | 22.6 (20.44 to 24.76) | 27 (25.63 to 28.37) | - | - | - | - |
▪ 6th - 9th births | 22.4 (20.46 to 24.42) | 29 (not calculated) | - | - | - | - |
▪ Mothers with nth birth; (1 ≤ n ≤ 8) | - | - | 1† | - | 1† | - |
▪ Mothers with (n+1)th birth | - | - | 0.92 (0.89 to 0.96) | < 0.0001 | 0.93 (0.89 to 0.97) | 0.0006 |
Mode of delivery
| ||||||
Vaginal | 22.0 (21.15 to 22.88) | 27 (25.72 to 28.28) | 1†
| - | - | - |
▪ Operative delivery | 20.4 (18.95 to 21.92) | 25 (23.15 to 26.85) | 1.16 (1.01 to 1.32) | 0.0307 | - | - |
▪ Caesarean | 20.9 (19.10 to 22.71) | 25 (23.18 to 26.82) | 1.13 (0.96 to 1.31) | 0.1336 | - | - |
▪ Instrumental | 19.5 (16.88 to 22.03) | 24 (19.67 to 28.32) | 1.23 (0.98 to 1.53) | 0.0523 | - | - |
Effects of in-hospital infant feeding practices on breastfeeding cessation
Variable | Breastfeeding duration from KM analyses | Unadjusted Cox HR | P value | Adjusted Cox HRΦ
| P value | |
---|---|---|---|---|---|---|
Mean (95% CI) | Median (95% CI) | (95% CI) | (95% CI) | |||
Breastfeeding initiation
| ||||||
Within 1 hr | 22.2 (21.31 to 23.08) | 27 (25.70 to 28.29) | 1†
| - | - | - |
After 1 hr | 20.3 (18.83 to 21.77) | 24 (20.91 to 27.09) | 1.24 (1.08 to 1.42) | 0.0028 | - | - |
▪ After 1 hr to 48 hrs | 20.3 (18.95 to 21.61) | 25 (23.49 to 26.51) | 1.20 (1.04 to 1.39) | 0.0128 | - | - |
▪ After 48 hrs | 18.0 (13.43 to 22.57) | 17 (8.40 to 25.59) | 1.52 (1.07 to 2.17) | 0.0195 | - | - |
Formula in hospital
| ||||||
No formula | 22.8 (21.86 to 23.68) | 27 (26.08 to 27.92) | 1†
| - | 1†
| - |
Formula | 17.7 (16.53 to 18.89) | 17 (13.94 to 20.06) | 1.56 (1.36 to 1.78) | < 0.0001 | 1.50 (1.26 to 1.79) | < 0.0001 |
▪ Yes (informed choice) | 19.7 (17.56 to 21.87) | 20 (14.40 to 25.59) | 1.73 (1.44 to 2.07) | < 0.0001 | 1.91 (1.49 to 2.44) | < 0.0001 |
▪ Yes (medical indication) | 16.6 (14.93 to 18.18) | 17 (13.79 to 20.20) | 1.38 (1.14 to 1.68) | 0.0009 | 1.34 (1.09 to 1.65) | 0.0058 |
▪ Yes (other reasons) | 17.0 (14.54 to 19.50) | 18 (9.31 to 26.39) | 1.62 (1.20 to 2.18) | 0.0016 | 1.53 (1.07 to 2.17) | 0.0181 |
Teats in Hospital
| ||||||
No teats | 22.4 (21.56 to 23.26) | 27 (26.17 to 27.82) | 1†
| - | 1†
| - |
Yes | 17.2 (15.88 to 18.51) | 17 (14.42 to 19.58) | 1.61 (1.38 to 1.87) | < 0.0001 | 1.26 (1.04 to 1.53) | 0.0203 |
▪ Yes (informed choice) | 17.3 (15.52 to 19.14) | 18 (13.65 to 22.35) | 1.51 (1.23 to 1.87) | 0.0001 | 1.01 (0.77 to 1.33) | 0.9231 |
▪ Yes (other reasons) | 17.2 (15.35 to 19.05) | 17 (13.94 to 20.05) | 1.69 (1.39 to 2.06) | < 0.0001 | 1.32 (1.04 to 1.68) | 0.0221 |