Change in breastfeeding patterns in Scotland between 2004 and 2011 and the role of health policy.

BACKGROUND Substantial investments in promoting breastfeeding have taken place in the past 10 years in Scotland. This study assesses whether there were significant changes in breastfeeding initiation and mixed breastfeeding duration between 2004-2005 and 2010-2011. METHODS This study uses data from two nationally representative cohorts of babies in Scotland born between June 2004-May 2005 (N = 5030) and March 2010-February 2011 (N = 5838). Multivariate logistic regression for breastfeeding initiation and multivariate survival analysis for breastfeeding duration using cross-sectional data based on maternal recall were performed. RESULTS An increase in breastfeeding initiation from 60 to 63% was not significant (P = 0.125), and controlling for covariates, there was no significant cohort effect when comparing breastfeeding initiation between cohorts [odds ratio (OR) 1.02, 95% confidence interval (CI) 0.91-1.13]. For breastfeeding duration of up to 1 month, the 2010-11 cohort was more likely to give up breastfeeding sooner (HR 1.23, 95%CI 1.12-1.34). However, for breastfeeding durations of >1-6 months, or ≥6 months, the 2010-11 cohort was significantly less likely to give up breastfeeding sooner (HR 0.79, 95%CI 0.70-0.88 and HR 0.79, 95%CI 0.68-0.92, respectively). Breastfeeding duration increased the most among mothers with fewer educational qualifications, and mothers with no qualifications in 2010-11 were far less likely to stop breastfeeding early compared with their counterparts in 2004-05 (HR 0.32, 95%CI 0.17-0.58). CONCLUSION After the 1 month mark, babies born in 2010-11 were more likely to be breastfed for longer compared with those born in 2004-05, and this effect was particularly pronounced among more disadvantaged families. The potential causal role of health policy is discussed.