Married Mothers: Doing Right By Baby

Public-health officials throughout the industrialized world recognize the tremendous advantages—immunological, neurological, nutritional—that babies enjoy when their mothers breastfeed them.  Unfortunately, these officials have struggled to increase the number of mothers giving their infants such advantages.  But in a study recently completed at the Universities of Dundee and Leeds in the United Kingdom, epidemiologists will find strong evidence that the international retreat from wedlock is hurting the effort to encourage breastfeeding.

Keenly aware of “the short-term and long-term health benefits of breastfeeding for both mother and child,” the British researchers set out to create a statistical model for identifying women who are least likely to start and to continue breastfeeding.  The researchers see a need for such a statistical model at a time when “most developed countries report that a minority of infants are exclusively breastfeeding at 6 months (40% the Netherlands; 13% the USA),” even though the World Health Organization recommends that infants be exclusively breastfed for the first six months of life.”

To collect data for analysis, the researchers identified 355 women ages 16 and older in 2009-10 who had recently given birth at Dundee Hospital.  Among the social characteristics of these women that predict breastfeeding, marital status stands out sharply.

Among the significant predictors of initiating breastfeeding, “living with a husband or partner” attracts particular attention.  For this predictor, the researchers calculate a Relative Risk of 6.07.  In other words, a new mother living on her own is more than six times more likely to forego breastfeeding than a new married mother (p < 0.001).

Of course, a woman who starts breastfeeding may not continue this health-giving practice for the recommended six months.  But the benefits of breastfeeding are simply out of the question when the mother doesn’t even initiate the practice.  And it is disproportionately unmarried mothers who make the unfortunate decision not even to try breastfeeding.

The authors of the new study hope that their findings “can be used to identify women who need additional support as well as to inform the design of interventions to promote and support breastfeeding.”  “Antenatal and public health interventions,” they suggest, “should aim to improve attitudes to breastfeeding generally and improve women’s confidence in their ability to breastfeed.”  The researchers further suggest that “increased levels of support, perhaps from other women who have successfully breastfed, might be an effective intervention strategy.” 

But the data for this new study clearly indicate that the support that might be most helpful in encouraging breastfeeding would be from husbands.   The authors of the study seem obliquely to acknowledge as much when they identify “maternal demographics” (such as marital status) as a predictor of “initiation as well as duration of breastfeeding.”  However, they lay aside such demographics because they are “not amenable to behavioural-change interventions.”  To be sure, fostering wedlock is a formidable challenge in the anti-wedlock culture of the twenty-first century.  But the data of this study make quite clear that anyone who seeks progress in giving babies the considerable benefits of breastfeeding must tackle that challenge.

(Peter T. Donnan et al., “Prediction of Initiation and Cessation of Breastfeeding from Late Pregnancy to 16 Weeks: The Feeding Your Baby [FYB] Cohort Study,” BMJ Open 3.8 [2013]: e003274, Web.)