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Region of birth, income and breastfeeding in a Swedish county
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Allmänpediatrisk forskning/Nordvall)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Allmänpediatrisk forskning/Nordvall)
2009 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 98, no 11, 1799-1804 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To study the relationship between maternal region of birth, disposable income and breastfeeding initiation and duration. METHODS: The study population consisted of 12,197 term born, singleton infants, born 1997-2001 in the county of Uppsala. Data on breastfeeding at 1 week, 6 months and 12 months were collected from the register of statistics of the Child Health Care Unit in Uppsala and socioeconomic indicators from Swedish national registers. Multivariate analysis was conducted using Cox regression. RESULTS: No influence of disposable income or region of birth on breastfeeding initiation was observed. Breastfeeding rates at 6 months were lower for mothers with disposable incomes in quartile 1-3 compared with mothers with the highest incomes in quartile 4 (hazard ratios (HRs) 0.88-0.90, adjusted HRs 0.92). The breastfeeding rates at 12 months were higher for mothers born in all regions compared with mothers born in Sweden (HRs 1.25-2.45, adjusted HRs 1.20-2.14). CONCLUSIONS: The findings in the present study show that disposable income is a strong predictor for breastfeeding at 6 months in the Swedish context. Region of birth of the mother predicted long term breastfeeding, > or =12 months. This calls for professionals in the maternity and child health care to pay extra attention to breastfeeding in low-income mothers in all ethnic groups.

Place, publisher, year, edition, pages
2009. Vol. 98, no 11, 1799-1804 p.
Keyword [en]
Breastfeeding, Ethnic, Infants, Smoking, Socioeconomic status
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-122207DOI: 10.1111/j.1651-2227.2009.01455.xISI: 000270549700020PubMedID: 19732040OAI: oai:DiVA.org:uu-122207DiVA: diva2:309491
Available from: 2010-04-07 Created: 2010-04-07 Last updated: 2012-04-13Bibliographically approved
In thesis
1. Lika för alla?: Social position och etnicitet som determinanter för amning, föräldrars rökvanor och kontakter med BVC
Open this publication in new window or tab >>Lika för alla?: Social position och etnicitet som determinanter för amning, föräldrars rökvanor och kontakter med BVC
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Child Health Services (CHS) in Sweden are offered free of charge to all Swedish parents with children 0-5 years of age.  The regular service schedule includes home visits, health examinations, vaccinations and participation in parenting groups. The CHS should pay extra attention to disadvantaged families.

The aim of this thesis was to investigate to what extent the CHS reaches groups of families with special needs, e.g. immigrant families, low income families, young and single mothers, with universal or selective measures, as well as to investigate the variation of two determinants of child health, second hand smoke and breastfeeding, in these groups of families. The thesis also aimed at investigating validity of data in the county CHS quality database (Basta). The thesis is based on data from Basta together with several national registers.

The CHS equally reached all families with infants with the universal program except for participation in parenting group. Foreign born, young, single and low-income mothers had lower participation rates. Smoking rates were lower in foreign-born than in Swedish-born mothers and higher for foreign-born than in Swedish-born fathers. Smoking was more common among single and low income parents and young mothers. Young and single mothers had lower breastfeeding rates at 6 months. At 12 months the breastfeeding rates were higher among foreign-born mothers. The validity test of data in the Basta database showed sensitivity values for immunizations, breastfeeding and smoking at 90-100 % and for any home visit, participation in parenting group at any time, a minimum number of 6 visits at the Child Health Centre (CHC) and a minimum number of 11 visits at the CHC at 88 - 96 %. The sensitivity value for the exact match of number of CHC visits (+/- 3 visits) was 88 %.

Conclusions: The universal programme was equally distributed in different immigrant and socio-demographic populations. However, the results did not indicate equality according to the assumption that some families need more input than others in order to achieve equity of outcome.

Individual data routinely collected from CHS records to a quality database provides data of good quality that can be used for both quality surveillance and research.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 125 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 752
Ethnic, infants, smoking, socio-economic status, second hand smoke, breastfeeding, child health services, child health care, health services research, mothers, parent participation, supportive care
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
urn:nbn:se:uu:diva-170037 (URN)978-91-554-8305-0 (ISBN)
Public defence
2012-05-04, Sal IX, Universitetshuset, Övre Slottsgatan 2, Uppsala, 09:00 (Swedish)
Available from: 2012-04-12 Created: 2012-03-07 Last updated: 2012-04-19

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