Chad Logan1, Tatjana Zittel1, Stefanie Striebel1, Frank Reister2, Hermann Brenner3, Dietrich Rothenbacher4, Jon Genuneit1. 1. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; 2. Department of Gynecology and Obstetrics, University Medical Center Ulm, Ulm, Germany; and. 3. Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. 4. Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany; dietrich.rothenbacher@uni-ulm.de.
Abstract
BACKGROUND: Breastfeeding is an important determinant of early infant immune function and potentially future health. Although numerous studies have reported rising breastfeeding initiation rates and duration, few longitudinally investigated the impact of shifting societal and lifestyle factors on breastfeeding patterns in developed nations. METHODS: The Ulm Birth Cohort Study (UBCS) and Ulm SPATZ Health Study (SPATZ) cohorts consist of newborns and their mothers recruited, respectively, from 2000 to 2001 and 2012 to 2013 at the University Medical Center Ulm, Germany. Cox proportional hazards models were used to estimate crude and mutually adjusted hazard ratios for study effect (time trend) and individual risk factors on noninitiation and duration of predominant and total breastfeeding. RESULTS: Compared with UBCS mothers, SPATZ mothers had lower cessation rates of both predominant breastfeeding by 4 months and total breastfeeding by 6 months: hazard ratio (95% confidence interval) 0.79 (0.67-0.93) and 0.71 (0.60-0.82), respectively. However, this crude time trend was limited to mothers with higher educational achievement. Similar time trend effects were observed among less educated mothers only after adjustment for early cessation risk factors. Mutually adjusted hazard ratios for individual risk factors were similar in both studies: low education, high BMI, smoking within 6 weeks of delivery, and cesarean delivery were associated with early breastfeeding cessation beginning at 6 weeks. In addition, actively abstaining from drinking alcohol was associated with lower rates of early cessation. CONCLUSIONS: Our results suggest widening socioeconomic disparity in breastfeeding and potentially subsequent child health, which may require new targeted interventions.
BACKGROUND: Breastfeeding is an important determinant of early infant immune function and potentially future health. Although numerous studies have reported rising breastfeeding initiation rates and duration, few longitudinally investigated the impact of shifting societal and lifestyle factors on breastfeeding patterns in developed nations. METHODS: The Ulm Birth Cohort Study (UBCS) and Ulm SPATZ Health Study (SPATZ) cohorts consist of newborns and their mothers recruited, respectively, from 2000 to 2001 and 2012 to 2013 at the University Medical Center Ulm, Germany. Cox proportional hazards models were used to estimate crude and mutually adjusted hazard ratios for study effect (time trend) and individual risk factors on noninitiation and duration of predominant and total breastfeeding. RESULTS: Compared with UBCS mothers, SPATZ mothers had lower cessation rates of both predominant breastfeeding by 4 months and total breastfeeding by 6 months: hazard ratio (95% confidence interval) 0.79 (0.67-0.93) and 0.71 (0.60-0.82), respectively. However, this crude time trend was limited to mothers with higher educational achievement. Similar time trend effects were observed among less educated mothers only after adjustment for early cessation risk factors. Mutually adjusted hazard ratios for individual risk factors were similar in both studies: low education, high BMI, smoking within 6 weeks of delivery, and cesarean delivery were associated with early breastfeeding cessation beginning at 6 weeks. In addition, actively abstaining from drinking alcohol was associated with lower rates of early cessation. CONCLUSIONS: Our results suggest widening socioeconomic disparity in breastfeeding and potentially subsequent child health, which may require new targeted interventions.
Authors: Michelle A Eilers; C Emily Hendrick; Rafael Pérez-Escamilla; Daniel A Powers; Joseph E Potter Journal: Pediatrics Date: 2020-03-18 Impact factor: 7.124
Authors: Chad A Logan; Rebecca Bornemann; Wolfgang Koenig; Frank Reister; Viola Walter; Giamila Fantuzzi; Maria Weyermann; Hermann Brenner; Jon Genuneit; Dietrich Rothenbacher Journal: Sci Rep Date: 2017-02-02 Impact factor: 4.379
Authors: Joris H J van Sadelhoff; Linda P Siziba; Lisa Buchenauer; Marko Mank; Selma P Wiertsema; Astrid Hogenkamp; Bernd Stahl; Johan Garssen; Dietrich Rothenbacher; Jon Genuneit Journal: Nutrients Date: 2021-06-10 Impact factor: 5.717
Authors: Linda P Siziba; Marko Mank; Bernd Stahl; John Gonsalves; Bernadet Blijenberg; Dietrich Rothenbacher; Jon Genuneit Journal: Nutrients Date: 2021-06-08 Impact factor: 5.717
Authors: Musa Abubakar Kana; Carina Rodrigues; Maria João Fonseca; Ana Cristina Santos; Henrique Barros Journal: Int Breastfeed J Date: 2018-04-10 Impact factor: 3.461