Evaluating Regional Differences in Breast-feeding in French Maternity Units: a Multi-level Approach

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2010 Jun 26

PMID 20576192

Citations 9

Authors

Mercedes Bonet

Beatrice Blondel

Babak Khoshnood

Affiliations

Soon will be listed here.

Abstract

Objectives: To study how individual and regional characteristics might explain regional variations in breast-feeding rates in maternity units and to identify outlier regions with very low or high breast-feeding rates.

Design: Individual characteristics (mother and infant) were collected during hospital stay. All newborns fed entirely or partly on breast milk were considered breast-fed. Regional characteristics were extracted from census data. Statistical analysis included multi-level models and estimation of empirical Bayes residuals to identify outlier regions.

Setting: All births in all administrative regions in France in 2003.

Subjects: A national representative sample of 13 186 live births.

Results: Breast-feeding rates in maternity units varied from 43 % to 80 % across regions. Differences in the distribution of individual characteristics accounted for 55 % of these variations. We identified two groups of regions with the lowest and highest breast-feeding rates, after adjusting for individual-level characteristics. In addition to maternal occupation and nationality, the social characteristics of regions, particularly the population's educational level and the percentage of non-French residents, were significantly associated with breast-feeding rates.

Conclusions: Social characteristics at both the individual and regional levels influence breast-feeding rates in maternity units. Promotion policies should be directed at specific regions, groups within the community and categories of mothers to reduce the gaps and increase the overall breast-feeding rate.

Citing Articles

The impact of the Baby-Friendly Hospital Initiative on breastfeeding rates at maternity units in France.

Guajardo-Villar A, Pelat C, Blondel B, Lebreton E, Demiguel V, Salanave B Int J Epidemiol. 2024; 53(3).

PMID: 38857529 PMC: 11164413. DOI: 10.1093/ije/dyae080.

Clinical significance and main parameters promoting the breast‑feeding strategy (Review).

Nixarlidou E, Margioula-Siarkou C, Almperis A, Vavoulidis E, Lagana A, Dinas K Med Int (Lond). 2024; 4(2):14.

PMID: 38410759 PMC: 10895466. DOI: 10.3892/mi.2024.138.

Trends and disparities in breastfeeding initiation in France between 2010 and 2016: Results from the French National Perinatal Surveys.

Guajardo-Villar A, Demiguel V, Smaili S, Boudet-Berquier J, Pilkington H, Blondel B Matern Child Nutr. 2022; 18(4):e13410.

PMID: 35909344 PMC: 9480949. DOI: 10.1111/mcn.13410.

Combining breastfeeding and work: findings from the Epifane population-based birth cohort.

Castetbon K, Boudet-Berquier J, Salanave B BMC Pregnancy Childbirth. 2020; 20(1):110.

PMID: 32066396 PMC: 7027215. DOI: 10.1186/s12884-020-2801-x.

Comparison of national cross-sectional breast-feeding surveys by maternal education in Europe (2006-2016).

Sarki M, Parlesak A, Robertson A Public Health Nutr. 2018; 22(5):848-861.

PMID: 30516455 PMC: 6474715. DOI: 10.1017/S1368980018002999.

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