Differential trends in breastfeeding according to maternal and hospital characteristics: results from the French National Perinatal Surveys

Aim: To assess breastfeeding trends in hospital, between 1998 and 2003, according to several characteristics of mothers and maternity units. Methods: Two representative national samples of births, comprising 13,600 live births in 1998 and 14,580 in 2003 were used. Data were collected during hospital stay. All newborns fed entirely or partly on breast milk were considered 'breastfed'. Univariate and multivariate analyses were used to compare the results for the 2 years. Results: Breastfeeding increased in all groups, but this increase varied slightly according to maternal age and the size of the maternity unit. For example, high rates of breastfeeding tended to be concentrated in large maternity units (>= 1500 deliveries per year) in 1998, but were also found in middle-size units (1000-1499 deliveries per year) in 2003. In 2003, women were more likely to breastfeed if they were at least 25 years old, primiparous, non-French or from a highly qualified occupational group, or if they gave birth in a university hospital or in a maternity unit with more than 1000 deliveries per year. Conclusion: Despite recent efforts to increase the breastfeeding rate, clear social disparities persist and further efforts are required, targeting particular groups of mothers less likely to breastfeed.