The relationship between breastfeeding and maternal education and family income

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


Aim. To assess the relationship between breastfeeding and maternal education and family income in Samara.

Methods. A survey was conducted among 174 mothers in the children's outpatient clinic, in which their children were assigned at the place of residence. Information on breastfeeding and its duration, mother's education, and family income were obtained by questionnaire and copying data from outpatient records. Pearson's chi-square, Mann–Whitney U test and logistic regression were used in the statistical processing of the data.

Results. There was a positive association of maternal education (χ2=11.25; p=0.024) and income (χ2=11.5; p=0.022) with breastfeeding practices. Higher education, compared with specialized secondary or secondary education, increased the likelihood of breastfeeding for more than 6 months with an odds ratio of 2.6 (95% confidence interval 1.18–5.73; p=0.018). The median (and its Q1–Q3 quartiles) breastfeeding duration was 4.0 months (Q1–Q3 2.0–14.0 months) for mothers with secondary or specialized secondary education and 12.0 months (Q1–Q3 4.0–18.0 months; p=0.012) for mothers with higher education. It was found that 67.7% of women with incomes above the subsistence level per family member ($150) breastfed for more than 7 months and only 43.9% of women with incomes below the subsistence level (p=0.011). The likelihood of breastfeeding for more than 6 months in household income above one minimum wage per family member compared with household income below increases with an odds ratio of 2.18 (95% confidence interval 1.03–4.60; p=0.041). There was no relationship between lactation cessation and maternal education or family income.

Conclusion. There is a positive relationship between mother's education and family income and the practice of breastfeeding.

Full Text

Restricted Access

About the authors

A A Bezrukova

Samara State Medical University

Russian Federation, Samara, Russia

M I Yarmolinskaya

Samara State Medical University

Russian Federation, Samara, Russia

O V Sazonova

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology

Russian Federation, Saint Petersburg, Russia

N V Spiridonova

Samara State Medical University

Russian Federation, Samara, Russia

M N Komarova

Samara State Medical University; Samara National Research University

Author for correspondence.
Russian Federation, Samara, Russia; Samara, Russia


  1. Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018. Implementation guidance. World Health Organization, UNICEF. (access date: 24.12.2020).
  2. Natsional'naya programma optimizatsii vskarmlivaniya detey pervogo goda zhizni v Rossiyskoy Federatsii. (The national program of optimization of feeding of children of the first year of life in the Russian Federation.) Approved at the XVI Congress of Pediatricians of Russia. February 2009. Moscow. 2010; 68 p. (access date: 24.12.2020) (In Russ.)
  3. Vandenplas Y. Oligosaccharides in infant formula. Br. J. Nutr. 2002; 87 (2): S293–S296. doi: 10.1079/BJNBJN/2002551.
  4. Sovremennye rekomendatsii po pitaniyu detey. (Modern recommendations for children's nutrition.) Ed. by Yu.G. Mukhina, I.Ya. Kon`. M.: Medpraktika-M. 2010; 568 p. (In Russ.)
  5. Netrebenko O.K. Nutrition and growth of the infant: long-term consequences and the connection with diseases. Pediatriya. 2009; 88 (5): 72–76. (In Russ.)
  6. Speranskiy G.N. Rebenok rannego vozrasta. (Child of early age.) M.-L.: Medgiz. 1940; 120 p. (In Russ.)
  7. Rukovodstvo po detskomu pitaniyu. (Child Nutrition Guide.) Ed. by V.A. Tutel'yan, I.Ya. Kon`. M.: MIA. 2004; 662 p. (In Russ.)
  8. Hawkins S.S., Stern A.D., Baum C.F., Gillman M.W. Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis. Public Health Nutr. 2015; 18 (2): 189–197. doi: 10.1017/S1368980014000238.
  9. Meyrose A.K., Klasen F., Otto C., Gniewosz G., Lampert T., Ravens-Sieberer U. Benefits of maternal edu­cation for mental health trajectories across childhood and ­adolescence. Soc. Sci. Med. 2018; 202: 170–178. doi: 10.1016/j.socscimed.2018.02.026.
  10. Güneş P.M. The role of maternal education in child health: evidence from a compulsory schooling law. Econom. Educ. Rev. 2015; 47: 1–16. doi: 10.1016/j.econedurev.2015.02.008.
  11. Wallby T., Hjern A. Region of birth, income and breastfeeding in a Swedish county. Acta Paediatr. 2009; 98: 1799–1804. doi: 10.1111/j.1651-2227.2009.01455.x.
  12. Cattaneo A. Academy of breastfeeding medicine founder's lecture 2011: inequalities and inequities in breastfeeding: an international perspective. Breastfeed Med. 2012; 7 (1): 3–9. doi: 10.1089/bfm.2012.9999.
  13. Brown A.E., Raynor P., Benton D., Lee M.D. Indices of multiple deprivation predict breastfeeding duration in England and Wales. Eur. J. Public. Health. 2010; 20 (2): 231–235. doi: 10.1093/eurpub/ckp114.
  14. Ibanez G., de Reynal de Saint Michel C., Denan­tes M., Saurel-Cubizolles M.J., Ringa V., Magnier A.M. Systematic review and meta-analysis of randomized controlled trials evaluating primary care-based interventions to promote breastfeeding in low-income women. Fam. Pract. 2012; 29 (3): 245–254. doi: 10.1093/fampra/cmr085.
  15. Acharya P., Khanal V. The effect of mother’s educational status on early initiation of breastfeeding: further analysis of three consecutive Nepal Demographic and Health Surveys. BMC Public Health. 2015; 15: 1069. doi: 10.1186/s12889-015-2405-y.
  16. Heck K.E., Braveman P., Cubbin C., Chávez G.F., Kiely J.L. Socioeconomic status and breastfeeding initiation among California mothers. Public Health Rep. 2006; 121 (1): 51–59. doi: 10.1177/003335490612100111.
  17. Skafida V. The relative importance of social class and maternal education for breast-feeding initiation. Public Health Nutr. 2009; 12: 2285–2292. doi: 10.1017/S1368980009004947.
  18. Busck-Rasmussen M., Villadsen S.F., Norsker F.N., Mortensen L., Andersen A.M. Breastfeeding practices in relation to country of origin among women living in Denmark: a population-based study. Matern. Child Health J. 2014; 18 (10): 2479–2488. doi: 10.1007/s10995-014-1486-z.
  19. Baerug A., Laake P., Løland B.F., Tylleskär T., Tufte E., Fretheim A. Explaining socioeconomic inequalities in exclusive breast feeding in Norway. Arch. Dis. Child. 2017; 102 (8): 708–714. doi: 10.1136/archdischild-2016-312038.
  20. Levinienė G., Tamulevičienė E., Kudzytė J., Petra­uskienė A., Zaborskis A., Aželienė I., Labanauskas L. Factors associated with breastfeeding duration. ­Medicina (Kaunas). 2013; 49 (9): 415–421. doi: 10.3390/medicina49090065.
  21. Kooijman M.N., Kruithof C.J., van Duijn C.M., Du­ijts L., Franco O.H., van Jzendoorn M.H., de Jongste J.C., Klaver C.C., van der Lugt A., Mackenbach J.P., Moll H.A., Pee­ters R.P., Raat H., Rings E.H., Rivadeneira F., van der Schroeff M.P., Steegers E.A., Tiemeier H., Uitterlinden A.G., Ver­hulst F.C., Wolvius E., Felix J.F., Jaddoe V.W. The Gene­ration R Study: design and cohort update 2017. Eur. J. Epidemiol. 2016; 31 (12): 1243–1264. doi: 10.1007/s10654-016-0224-9.
  22. Alemayehu T., Haidar J., Habte D. Determinants of exclusive breastfeeding practices in Ethiopia. Ethiopian J. Health Develop. 2009; 23 (1): 12–18. doi: 10.4314/ejhd.v23i1.44832.
  23. Mihrshahi S., Kabir I., Roy S.K., Agho K.E., Sena­rath U., Dibley M.J., South Asia Infant Feeding Research Network. Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004. Food Nutr. Bulln. 2010; 31 (2): 295–313. doi: 10.1177/156482651003100220.
  24. Robertson A. Breastfeeding initiation at birth can help reduce health inequalities. Entre Nous. 2015; (81): 21–22.
  25. Hoffmann R., Eikemo T.A., Kulhánová I., Kulik M.C., Looman C., Menvielle G., Deboosere P., Martikainen P., Regidor E., Mackenbach J.P. Obesity and the potential reduction of social inequalities in mortality: evidence from 21 European populations. Eur. J. Public Health. 2015; 25: 849–856. doi: 10.1093/eurpub/ckv090.
  26. Decree of the Government of the Samara Region No. 533 issued at 06.08.2019 “On establishing the ­value of the subsistence minimum in the Samara Region for the II quarter of 2019 per capita and for the main socio-­demographic groups”.­content/uploads/sites/2/2019/08/0608_533.pdf (access date: 17.03.2021). (In Russ.)
  27. Victora C.G., Bahl R., Barros A.J., França G.V., Horton S., Krasevec J., Murch S., Sankar M.J., Walker N., Rollins N.C.; Lancet Breastfeeding Series Group. Breastfee­ding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387: 475–490. doi: 10.1016/S0140-6736(15)01024-7.
  28. Capture the moment. Early initiation of breastfee­ding: The best start for every newborn. New York: UNICEF. 2018. _the_moment_EIBF_2018.pdf (access date: 24.12.2020).

Supplementary files

Supplementary Files
1. Рис. 1. Продолжительность грудного вскармливания (ГВ) в зависимости от уровня семейного дохода в г. ­Самаре в 2019 г.

Download (25KB)
2. Рис. 2. Причины прекращения грудного вскармливания в зависимости от уровня образования матери и величины ­семейного дохода в г. Самаре в 2019 г.

Download (46KB)

© 2021 Bezrukova A.A., Yarmolinskaya M.I., Sazonova O.V., Spiridonova N.V., Komarova M.N.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies