Mothers with higher education level breastfeed longer

A study of 250 mothers of eight-month-old infants may have linked education levels to the incidence of breastfeeding, finding women with lower education relying more and more on formula milk for their babies.

The study, published in the Malta Journal of Health Sciences, was based on the responses of mothers recruited from six well-baby clinics and outpatient departments across Malta and Gozo.

The data finds that 43% of mothers classified at a lower level of education were feeding their children exclusively formula milk.

In contrast, only 22% of those with a higher level of education did likewise.

Mothers with a low level of education had decided to stop breastfeeding at just 2.6 months, while mothers with a post-secondary level of education continued to breastfeed for about four months.

Overall, during the first eight months, nearly half of all mothers relied on a combination of breast and formula milk (48%) while 22% relied on breast milk only and 29% used formula milk only.

But the percentage of those who used formula milk only was higher among 18-24 year-olds (45%) and among those aged over 35 (39.6%).

The study also suggests that housewives are more likely to rely on formula milk than working mothers. While 23% of both categories rely solely on breast milk, 38% of housewives and 24% of employed mothers rely solely on formula milk. On the other hand, working mothers are more likely to rely on a combination of formula and breast milk (53%) than housewives (39%).

The study, authored by Justine Parnis Ignjatovic and Petra Jones from the University of Malta’s Faculty of Health Sciences, which focused on health inequalities, found that 42.1% of mothers were still breastfeeding their infants at eight months. But on average breastfeeding was stopped when the infant was 3.6 months old.

The duration of breastfeeding falls short of the recommendations set by the World Health Organisation which recommends exclusive breastfeeding during the first six months of life.

One possible reason accounting for these health inequalities, according to the study, is that better-educated mothers are more mentally prepared for the post-partum period, enabling them to breastfeed for longer. This preparedness is often supported by greater emotional and practical help, which less educated mothers may lack.

The authors recommended more targeted public health interventions and community support that address these socio-economic factors.

“By tackling the disparities in maternal education and age, public health initiatives can work towards reducing health inequalities and improving infant feeding practices across the Maltese island,” they said.

The study also highlights the urgent need for public health policies that address the socio-economic factors influencing infant feeding practices. “Ensuring that all mothers receive adequate support and education is essential for promoting optimal breastfeeding and weaning practices, which are crucial for the health and well-being of infants in Malta. Strengthened community support and tailored public health strategies must be implemented to support younger and less educated mothers in their breastfeeding and weaning journeys, ultimately fostering better health for future generations.”

Other findings

The study highlighted that nearly all infants were weaned at the appropriate age, with only 1.2% being weaned when they were younger than four months, and 3.6% being weaned when they were older than 6 months.

This suggests that, despite variations in breastfeeding duration, most mothers are following recommended weaning practices.

Less than 4% of participants relied exclusively on store-bought products for weaning while over 71% relied solely on home-made foods. The study found no significant variations based on the employment and education status of respondents.

But respondents with a higher level of education and who were employed were more likely to use both home-made and store-bought products. In both categories 27% opted for a mix. On the other hand, only 22% of mothers with a low level of education or who are not employed did likewise.

But respondents with a low level of education and who were not employed, were more likely to rely solely on store bought products. In fact, while only 2% of mothers with a high education and 1% of employed mothers relied solely on store-bought food, the percentage rises to 7% among those with a lower level of education and to 8% amongst those who were not in employment.