The relative importance of social class and maternal education for breast-feeding initiation.

OBJECTIVE To examine changes in breast-feeding take-up rates among young children in Scotland and to assess whether maternal education or occupation-based social class is a stronger and better predictor of breast-feeding take-up. DESIGN Binary logistic regression models were developed from the first sweep of the Growing Up in Scotland longitudinal survey, for the two cohorts of children. SETTING A national representative survey for Scotland. SUBJECTS A baby cohort of 5012 singletons born over a 12-month period between June 2004 and May 2005, and a toddler cohort of 2732 singletons born over a 12-month period between June 2002 and May 2003. RESULTS Mothers from more privileged social classes and those with more educational qualifications resulted as more likely to breast-feed. However, maternal education was a better and more robust predictor of breast-feeding take-up compared with social class. There were no significant differences in breast-feeding take-up between the two cohorts and only minor differences between mothers aged 20-29 years and those who stated an intention to bottle-feed prior to birth. CONCLUSIONS The study suggests that the importance of maternal education in influencing breast-feeding has been somewhat overlooked in research based in more developed countries. The results indicate that, compared with occupation-related social class, maternal education is a more informative, accurate and useful lens through which to understand and explain patterns of breast-feeding take-up.