Investigation of observed increases in breastfeeding rates in deprived areas

We undertook a study, aiming to contribute to a better understanding of the influence of parental characteristics, socioeconomic factors, cultural background and health services on infant feeding patterns in Scotland. In addition, we have been able to examine the potential health and economic benefits of exclusive breastfeeding on health in early childhood. 

This project has had two phases, both joint-funded by the Scottish Centre for Public Health Research and Policy (SCPHRP) and the Centre.

Phase 1 

Work in this phase focussed on understanding increases in breastfeeding rates observed in selected neighbourhoods in NHS Greater Glasgow and Clyde (NHS GGC) between 1997 and 2008. In addition, the project investigated national trends and analyses in infant feeding using linked data. 

The project had both national and local objectives: 

  • To identify demographic, socioeconomic, structural or cultural changes that influence national and local (NHS GGC) breastfeeding rates.
  • To understand the impact of a range of individual, cultural  and socioeconomic factors such as maternal age, previous breastfeeding history, deprivation and ethnic background on the likelihood and duration of breastfeeding in the selected neighbourhoods and across Scotland.
  • To determine the best data sources and methods that may be used to understand infant feeding patterns in NHS GGC and nationally. 

A literature review developed during Phase 1 is available and a journal article was published from this phase of work: 

Informing the ‘early years’ agenda in Scotland: understanding infant feeding patterns using linked datasets
Ajetunmobi O, Whyte B, Chalmers J, Fleming M, Stockton D, Wood R. Journal of Epidemiology and Community Health. DOI:10.1136/jech-2013-202718 

Phase 2 

Initially in this phase, we investigated whether there was a hospital effect on infant feeding, independent of Baby Friendly Accreditation, in Glasgow using the existing linked dataset (created in phase 1). 

The more substantial part of this phase has involved extending the maternal and infant linked dataset through linkage to infant hospitalisation records, primary care consultations and child health surveillance records (at pre-school and primary 1 school review).

The creation of this resource has enabled an analysis of patterns of morbidity, hospitalisation and weight gain, comparing children who were breastfed, mixed fed or bottle-fed.  A paper which described how exclusive breastfeeding is associated with reduced childhood illness and hospitalisation has been published:

Breastfeeding is Associated with Reduced Childhood Hospitalization: Evidence from a Scottish Birth Cohort (1997-2009),  Ajetunmobi OM, Whyte B, Chalmers J, Tappin DM, Wolfson L, Fleming M, MacDonald A,Wood R, Stockton DL. Journal of Pediatrics, 2014.

We have estimated the potential economic savings from reduced morbidity and hospitalisation among breastfed infants compared to bottle-fed infants.  A paper on this work is being prepared for submission to a peer review journal. 

Project management 

The project was led by Bruce Whyte (GCPH) with support from an advisory group: Jim Chalmers (Public Health Consultant, ISD Scotland), Linda Wolfson (Infant Feeding Advisor, NHS GGC), Diane Stockton (ISD Scotland), Ali MacDonald, Kate Woodman (Public Health Advisors, NHS Health Scotland), Helen Yewdell (Scottish Government), David Tappin (Senior Clinical Lecturer, PEACH Unit, Royal Hospital for Sick Children, Glasgow) and Rachel Wood (Public Health Consultant, ISD Scotland). ‘Tomi Ajetunmobi is the project researcher (seconded from ISD Scotland). 

For further information please contact Bruce Whyte

Related topic: Population health trends