In this study, we revealed that the higher parents’ income and education level, the higher the breastfeeding rate; and the younger fathers’ age, the lower the breastfeeding rate.
Multiple factors influence breastfeeding. These factors were classified into four groups: demographic, biological, social, and psychological. Demographic factors that affect the breastfeeding rate include race, maternal age, marital status, socioeconomic status, and education level.13In this study, we examined demographic variables that affect breastfeeding.
In this study, most parents were in their 30s and most breastfed their infants; however parental age did not affect breastfeeding. Other studies showed same results.14,15 However, several previous reports showed that the older the mothers were more likely to breastfeed than were younger mothers.16–18 Oakely et al19 reported that the younger the mother was, the less likely she was to breastfeed or to stop breastfeeding within 6 weeks. We posit that younger mothers lack knowledge and awareness of breastfeeding.
Banu et al20 stated that the higher the parents’ education level, the higher the exclusive breastfeeding rate and longer duration of the exclusive breastfeeding. In this study, parents’ education level was also related to breastfeeding. The higher the mother’s education level, the higher the breastfeeding rate. In model 1, maternal education level (≥ 13years) revealed highest breastfeeding rate. It is believed that the higher education level coincides with increased opportunities to access information about the benefits of breastfeeding.In high-income countries, mother’s education level is positively associated with higher breastfeeding rate.16,17,19,21–25 Even for mothers with a job, breastfeeding rate is estimated to be high, because the higher the level of education, the higher the occupational status, the better the working environment and the better knowing the benefits of breastfeeding. In middle- and low-income countries, the relationship between breastfeeding and mothers’ education level varies. Some studies have reported a negative relationship between mothers’ education level and the breastfeeding rate owing to quick return to work. 18,26 Another study showed a higher parental education level was associated with a higher breastfeeding rate and exclusive breastfeeding.27
We found a positive association between father’s education level and breastfeeding. Similar finding has been reported by Flacking et al 28, who found that the lower the fathers’ education level, the lower the breastfeeding rate. We posit that this is related to family income. Because higher education often results in a better income, mothers may not need to work and can focus on parenting. However, other study showed that mothers’-but not fathers’- education level was related breastfeeding,17 or that parental education level was not related to breastfeeding. 29,30
Further, in this study, there was no relationship between the mother’s income and breastfeeding, however, the higher the income of the father, the higher the breastfeeding rate. This is believed that non-working mother (full-time housewives) composed 65.17%, father is main source of family income. Therefore, the higher the father’s income, the greater the mother’s devotion to child care, and breastfeeding. Similar results have been reported that the lower the father’s income level, the shorter the breastfeeding duration.28 This may be related to easy finding a job for mother.
On the contrary, Wallby et al31 reported that higher breastfeeding rate in low-income households. This is believed to be due to the fact that there are no economic condition to choose a different formula besides breast milk and no easy finding a job for mother. Victoria et al 4 stated that high-income, better-educated women breastfeed more commonly in high-income countries. Due to economic benefits, the lower the household’s gross income, the higher the breastfeeding in low-income and middle-income countries. However, in other studies, household income did not affect breastfeeding. 15, 29
Maternal job status is variable that has been associated with breastfeeding. Previous studies 14,18,24 revealed that full-time houseswives have higher breastfeeding rates than mothers with work and the shorter the time to return to work after childbirth, the shorter the breastfeeding period. It is estimated that they stop breastfeeding because they have less time to care for the child while working. However, we did not find a significant association between breastfeeding and parental job status.
Importantly, our results shed light on some socioeconomic factors associated with breastfeeding; however, this study has some limitations. The utilized data were collected through self - report, and this is a source of recall bias which may have either underestimated or overestimated the relationship between the breastfeeding and socio-economic status. Further, causal relationships cannot be confirmed owing to the cross-sectional design of the KNHANES. Also, because it is a survey study, it was not possible to analyze the factors affecting breastfeeding according to the duration of breastfeeding. In addition to the factors used in this study, it is considered that studies on various social factors such as breastfeeding education, use rooming-in, use of postpartum care center, parental leave, and establishment of a breastfeeding room in the workplace are necessary.