Do early infant feeding practices vary by maternal ethnic group?

Objective. To examine UK country and ethnic variations in infant feeding practices. Design: Cohort study. Setting: Infants enrolled in the Millennium Cohort Study, born between September 2000 and January 2002. Subjects: A total of 18 150 natural mothers (11286 (8207 white) living in England) of singleton infants. Outcome measures: Breast-feeding initiation, breast-feeding discontinuation and introduction of solid foods before 4 months. Explanatory variables: Maternal ethnic group, education and social class. Results: Seventy per cent of UK mothers started to breast-feed, of whom 62% stopped before 4 months. Median age at discontinuing breast-feeding was 14, 13, 10 and 6 weeks in Scotland, England, Wales and Northern Ireland, respectively. Thirty-six per cent of UK mothers (34% in England) introduced solids before 4 months. White mothers were more likely to discontinue breast-feeding (62%) and introduce solids early (37%) than most other ethnic minority groups; those stopping before 4 months were more likely to introduce solids early compared with those continuing to breast-feed beyond this age (adjusted rate ratio (95% confidence interval): 1.3 (1.1-1.2)). Educated mothers were less likely to stop breast-feeding before 4 months (white mothers, 0.8 (0.8-0.9); non-white mothers, 0.9 (0.8-1.0)) than those with no/minimal qualifications but, among ethnic minorities, were more likely to introduce solids early (1-3 (1.0-1.6)). Socio-economic Status was positively associated with breast-feeding continuation among white women, and with age at introduction of solids among non-white women. Conclusions: We have identified important geographic, ethnic and social inequalities in breast-feeding continuation and introduction of solids within the UK, many of which have not been reported previously. The factors mediating these associations are complex and merit further study to ensure that interventions proposed to promote maternal adherence to current infant feeding recommendations are appropriate and effective.