Cent Eur J Public Health 2015, 23(1):39-44 | DOI: 10.21101/cejph.a4092

Immigrant Status as Important Determinant of Breastfeeding Practice in Southern Europe

Evangelia-Filothei Tavoulari1, Vassiliki Benetou1, Petros V. Vlastarakos2, George Kreatsas3, Athena Linos1
1 Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Athens, Greece
2 Otorhinolaryngology Department, MITERA Paediatric Infirmary, Athens, Greece
3 2nd Obstetrics and Gynaecology Department, Aretaieion University Hospital, Athens, Greece

Aim: Breastfeeding is universally accepted as the optimal way to nourish infants. There is evidence that socio-demographic factors, including immigrant status, are related to infant feeding practices. The aim of the present study was to identify the factors which are associated with breastfeeding initiation and duration, with special focus on the role of immigrant status of the mother in breastfeeding practice. A sample of mothers giving birth and living in Athens, Greece, was investigated.

Methods: 428 mothers (438 infants) were recruited in the maternity ward of a Tertiary University Hospital, and were interviewed using a structured questionnaire. Monthly telephone interviews were subsequently conducted until the sixth postpartum month. Multivariate logistic regression models were used to quantify the association of socio-demographic parameters with breastfeeding initiation. Cox regression analysis was employed to assess related factors that might influence breastfeeding duration.

Results: Being an immigrant was positively associated with exclusive as well as partial breastfeeding initiation (OR 7.97, 95% CI 1.02-62.19). Immigrant mothers were also 0.35 times less likely (95% CI 0.21-0.58) to stop breastfeeding earlier, compared to the native ones. Several other factors were deemed important either for breastfeeding initiation or its duration but not for both aspects of breastfeeding practice.

Conclusion: Maternal immigrant status was found to be consistently associated with breastfeeding initiation and duration in this study sample. Health professionals, health policy makers and politicians should remain attuned to the cultural backgrounds which have created strong breastfeeding traditions, to further promote breastfeeding practice in Western countries.

Keywords: lactation, breastfeeding, formula, duration, exclusive, mother, newborn, immigrant

Received: September 6, 2014; Revised: December 12, 2014; Accepted: December 12, 2014; Published: March 1, 2015  Show citation

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Tavoulari E, Benetou V, Vlastarakos PV, Kreatsas G, Linos A. Immigrant Status as Important Determinant of Breastfeeding Practice in Southern Europe. Cent Eur J Public Health. 2015;23(1):39-44. doi: 10.21101/cejph.a4092. PubMed PMID: 26036097.
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References

  1. Bolton TA, Chow T, Benton PA, Olson BH. Characteristics associated with longer breastfeeding duration: an analysis of a peer counseling support program. J Hum Lact. 2009 Feb;25(1):18-27. Go to original source... Go to PubMed...
  2. Bolling K, Grant C, Hamlyn B, Thornton A. Infant feeding survey 2005. London: Government Statistical Service, The Information Centre; 2007.
  3. Kimbro RT. On-the-job moms: work and breastfeeding initiation and duration for a sample of low-income women. Matern Child Health J. 2006 Jan;10(1):19-26. Go to original source... Go to PubMed...
  4. Kruse L, Denk CE, Feldman-Winter L, Rotondo FM. Comparing sociodemographic and hospital influences on breastfeeding initiation. Birth. 2005 Jun;32(2):81-5. Go to original source... Go to PubMed...
  5. Rea MF. Benefits of breastfeeding and women's health. J Pediatr (Rio J). 2004 Nov;80(5 Suppl):S142-6. (In Portuguese.) Go to original source... Go to PubMed...
  6. U.S. Department of Health and Human Services, Office on Women's Health. Breastfeeding: HHS blueprint for action on breastfeeding. Washington, DC: U.S. Department of Health and Human Services; 2000.
  7. World Health Organization. Protecting, promoting, and supporting breastfeeding: the special role of maternity services. A joint WHO/UNICEF statement. Geneva: WHO; 1989.
  8. World Health Organization; UNICEF. Innocenti declaration on the protection, promotion, and support of breastfeeding. In: Breastfeeding in the 1990's: a global initiative meeting in Florence, Italy. Geneva: WHO; 1990.
  9. World Health Organization; UNICEF. Baby-Friendly Hospital Initiative and program manual. Geneva: WHO; 1992.
  10. Sloper K, McKean KL, Baum JD. Factors influencing breast feeding. Arch Dis Child. 1975 Mar;50(3):165-70. Go to original source...
  11. Peters E,Wehkamp KH, Felberbaum RE, Krüger D, Linder R. Breastfeeding duration is determined by only a few factors. Eur J Public Health. 2006 Apr;16(2):162-7. Go to original source... Go to PubMed...
  12. Río I, Castelló-PastorA, Del Val Sandín-Vázquez M, Barona C, Jané M, Más R, et al. Breastfeeding initiation in immigrant and non-immigrant women in Spain. Eur J Clin Nutr. 2011 Dec;65(12):1345-7. Go to original source... Go to PubMed...
  13. KellyYJ, Watt RG, Nazroo JY. Racial/ethnic differences in breastfeeding initiation and continuation in the United Kingdom and comparison with findings in the United States. Pediatrics. 2006 Nov;118(5):e1428-35. Go to original source... Go to PubMed...
  14. Merewood A. Race, ethnicity, and breastfeeding. Pediatrics. 2006 Oct;118(4):1742-3. Go to original source... Go to PubMed...
  15. World Health Organization, Division of Child Health and Development. Indicators for assessing breastfeeding practices: reprinted report of an Informal Meeting, 11-12 June 1991, Geneva, Switzerland. Geneva:WHO; 1991.
  16. Guttman N, Zimmerman DR. Low-income mothers' views on breastfeeding. Soc Sci Med. 2000 May;50(10):1457-73. Go to original source...
  17. CattaneoA, Burmaz T,Arendt M, Nilsson I, Mikiel-Kostyra K, Kondrate I, et al. 'Promotion of Breastfeeding in Europe: Pilot Testing the Blueprint for Action' Project. Protection, promotion and support of breastfeeding in Europe: progress from 2002 to 2007. Public Health Nutr. 2010 Jun;13(6):751-9. Go to original source... Go to PubMed...
  18. Dennis CL. Breastfeeding initiation and duration: a 1990-2000 literature review. J Obstet Gynecol Neonatal Nurs. 2002 Jan-Feb;31(1):12-32. Go to original source...
  19. Singh GK, Kogan MD, Dee DL. Nativity/immigrant status, race/ethnicity, and socioeconomic determinants of breastfeeding initiation and duration in the United States, 2003. Pediatrics. 2007 Feb;119 Suppl 1:S38-46. Go to original source... Go to PubMed...
  20. National Statistical Service of Greece.Announcing the socio-demographic characteristics of the permanent population of Greece, according to the population-estates census of 2011. Press Bulletin. Piraeus; 2013. (In Greek.)
  21. Vasileva K. Population and social conditions. Statistics in focus [Internet]. 2011 [cited 2014 Dec 12];(34):1-8. Available from: http://ec.europa.eu/eurostat/documents/3433488/5579176/KS-SF-11-034-EN.PDF/63cebff3f7ac-4ca6-ab33-4e8792c5f30c.
  22. Gaki E, Papamichael D, Sarafidou J, Panagiotopoulos T, AntoniadouKoumatou I. National Survey of prevalence and determinants of maternal breastfeeding. Report of the Institute of Children's Health/National School of Public Health - Sector of Children's Health.Athens; 2009. (In Greek.)
  23. Grossman LK, Fitzsimmons SM, Larsen-Alexander JB, Sachs L, Harter C. The infant feeding decision in low and upper income women. Clin Pediatr (Phila). 1990 Jan;29(1):30-7. Go to original source... Go to PubMed...
  24. Lawson K, Tulloch MI. Breastfeeding duration: prenatal intentions and postnatal practices. J Adv Nurs. 1995 Nov;22(5):841-9. Go to original source... Go to PubMed...
  25. QuarlesA, Williams PD, Hoyle DA, Brimeyer M, WilliamsAR. Mothers' intention, age, education and the duration and management of breastfeeding. Matern Child Nurs J. 1994 Jul-Sep;22(3):102-8.
  26. Bonuck KA, Freeman K, Trombley M. Country of origin and race/ethnicity: impact on breastfeeding intentions. J Hum Lact. 2005Aug;21(3):3206. Erratum in: J Hum Lact. 2005 Nov;21(4):506. Go to original source... Go to PubMed...
  27. De Amici D, Gasparoni A, Guala A, Klersy C. Does ethnicity predict lactation? A study of four ethnic communities. Eur J Epidemiol. 2001;17(4):357-62. Go to original source...
  28. Gibson-Davis CM, Brooks-Gunn J. Couples' immigration status and ethnicity as determinants of breastfeeding. Am J Public Health. 2006 Apr;96(4):641-6. Go to original source... Go to PubMed...
  29. Rossiter JC. Attitudes of Vietnamese women to baby feeding practices before and after immigration to Sydney, Australia. Midwifery. 1992 Sep;8(3):103-12. Go to original source... Go to PubMed...
  30. Heck KE, Braveman P, Cubbin C, Chávez GF, Kiely JL. Socioeconomic status and breastfeeding initiation among California mothers. Public Health Rep. 2006 Jan-Feb;121(1):51-9. Go to original source... Go to PubMed...
  31. National Statistical Service of Greece. Household Budget Survey for the year 2009. Press Bulletin. Piraeus; 2012. (In Greek.)