Nam Mi Kang; Jung Eun Lee; Yeon Bai; Theo Van Achterberg; Taisun Hyun

doi:10.4040/jkan.2015.45.2.306

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Original Article
Breastfeeding Initiation and Continuation by Employment Status among Korean Women: Nam Mi Kang¹, Jung Eun Lee², Yeon Bai³, Theo Van Achterberg⁴, Taisun Hyun⁵; Journal of Korean Academy of Nursing 2015;45(2):306-313.
DOI: https://doi.org/10.4040/jkan.2015.45.2.306
Published online: April 15, 2015

¹Department of Nursing, Konkuk University, Chungju

²Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea

³Department of Health and Nutrition Sciences, Montclair State University, Montclair, NJ, USA

⁴Department of Nursing Science, KU Leuven, Leuven, Belgium

⁵Department of Food and Nutrition, Chungbuk National University, Cheongju, Korea

¹Department of Nursing, Konkuk University, Chungju

²Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea

³Department of Health and Nutrition Sciences, Montclair State University, Montclair, NJ, USA

⁴Department of Nursing Science, KU Leuven, Leuven, Belgium

⁵Department of Food and Nutrition, Chungbuk National University, Cheongju, Korea

Address reprint requests to : Hyun, Taisun Department of Food and Nutrition, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju 362-763, Korea Tel: +82-43-261-2790 Fax: +82-43-267-2742 E-mail: taisun@chungbuk.ac.kr

• Received: October 10, 2014 • Revised: October 31, 2014 • Accepted: January 23, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
REFERENCES

Abstract

Purpose
The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status.
Methods
Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers’ employment status.
Results
Breastfeeding initiation rates were similar regardless of mothers’ employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers.
Conclusion
These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.
Keywords: Breastfeeding; Employment; Web

Figure 1.

Breastfeeding rate at initiation, 1, 6 and 12 months.

Table 1.

Characteristics of the Participants

Characteristics	Variables	Categories	Total	Unemployed	Employed	p
			(N=1,031)	mothers (n=655)	mothers (n=376)
			n (%) or M±SD	n (%) or M±SD	n (%) or M±SD
Mother	Age (yr)	<30	327 (31.7)	235 (35.9)	92 (24.5)	<.001
		≥30	704 (68.3)	420 (64.1)	284 (75.5)
	Education	<University	306 (29.7)	235 (35.9)	71 (18.9)	<.001
		≥University graduate	725 (70.3)	420 (64.1)	305 (81.1)
	Infant feeding plan	Prior to pregnancy	648 (62.9)	434 (66.3)	214 (56.9)	.003
		After pregnancy	383 (37.1)	221 (33.7)	162 (43.1)
	BF education experience	No	324 (31.4)	195 (29.8)	129 (34.3)	.131
		Yes	707 (68.6)	460 (70.2)	247 (65.7)
	BF knowledge score		8.89±1.83	8.75±1.87	9.13±1.72	.001
Infant	Gender	Boy	529 (51.3)	335 (51.2)	194 (51.6)	.889
		Girl	502 (48.7)	320 (48.8)	182 (48.4)
	Birth order	1	656 (63.6)	402 (61.4)	254 (67.5)	.047
		≥2	375 (36.4)	253 (38.6)	122 (32.5)
	Having atopic dermatitis	No	785 (76.1)	500 (76.3)	285 (75.8)	.845
		Yes	246 (23.9)	155 (23.7)	91 (24.2)
Health-care	Delivery place	Private hospital	682 (66.1)	450 (68.7)	232 (61.7)	.022
		General hospital	349 (33.9)	205 (31.3)	144 (38.3)
	Delivery type	Vaginal delivery	676 (65.6)	423 (64.6)	253 (67.3)	.379
		Cesarean section	355 (34.4)	232 (35.4)	123 (32.7)
	Rooming-in	No	672 (65.2)	413 (63.0)	259 (68.9)	.059
		Yes	359 (34.8)	242 (37.0)	117 (31.1)
	BF during hospital stay	No	214 (20.8)	135 (20.6)	79 (21.0)	.879
		Yes	817 (79.2)	520 (79.4)	297 (79.0)

BF=Breastfeeding.

Table 2.

Adjusted Odds Ratios and Confidence Intervals for Breastfeeding Initiation by Multivariate Logistic Analysis^*

Variables	Categories	Total (N=1,031)			Unemployed mothers (n=655)			Employed mothers (n=376)
Variables	Categories	OR	95% CI	p	OR	95% CI	p	OR	95% CI	p
Mothers’ employment status	Not employed	1.00	0.59~1.70	.989
	Employed	1.00
Rooming-in	No	1.00	1.43~5.02	.002	1.00	1.25~5.74	.012	1.00	0.81~7.72	.109
	Yes	2.68			2.67			2.51
Atopic dermatitis of infant	No	1.00	1.16~4.99	.019	1.00	0.96~5.84	.060	1.00	0.62~7.98	.217
	Yes	2.40			2.37			2.23

^*All the variables in Table 1 except breastfeeding during hospital stay were included in the analysis and mothers’ employment status and the selected variables with significant association are presented.

Table 3.

Adjusted Odds Ratios and Confidence Intervals for Breastfeeding Continuation by Multivariate Logistic Analysis^*

Month	Variables	Categories	Total			Unemployed mothers			Employed mothers
Month	Variables	Categories	OR	95% CI	p	OR	95% CI	p	OR	95% CI	p
1 month	Mothers’ employment status	Unemployed	1.00	0.45~0.83	.001
		Employed	0.61
	BF during hospital stay	No	1.00	1.14~2.30	.007	1.00	1.35~3.28	.001	1.00	0.61~1.93	.795
		Yes	1.62			2.10			1.08
6 month	Mothers’ employment status	Unemployed	1.00	0.23~0.46	<.001
		Employed	0.33
	BF during hospital stay	No	1.00	1.18~2.64	.006	1.00	1.07~3.12	.026	1.00	0.93~3.28	.083
		Yes	1.77			1.83			1.75
	BF knowledge		1.13	1.03~1.23	.010	1.19	1.06~1.34	.004	1.04	0.91~1.20	.564
	Atopic dermatitis of infant	No	1.00	1.04~2.28	.031	1.00	0.92~2.61	.100	1.00	0.76~2.64	.276
		Yes	1.54			1.55			1.41
12 month	Mothers’ employment status	Unemployed	1.00	0.18~0.43	<.001
		Employed	0.28
	BF during hospital stay	No	1.00	1.15~3.37	.014	1.00	1.14~4.46	.020	1.00	0.70~4.34	.231
		Yes	1.97			2.25			1.75
	BF education experience	No	1.00	0.87~2.14	.178	1.00	0.56~1.86	.951	1.00	1.14~5.14	.021
		Yes	1.36			1.02			2.43
	Atopic dermatitis of infant	No	1.00	1.45~4.12	<.001	1.00	1.44~6.22	.003	1.00	0.78~4.07	.174
		Yes	2.44			2.99			1.78

^*All the variables in Table 1 were included in the analysis and the variables with significant association are presented; BF=Breastfeeding.

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Breastfeeding Initiation and Continuation by Employment Status among Korean Women

J Korean Acad Nurs. 2015;45(2):306-313. Published online April 15, 2015

DOI: https://doi.org/10.4040/jkan.2015.45.2.306

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Breastfeeding Initiation and Continuation by Employment Status among Korean Women

Figure 1. Breastfeeding rate at initiation, 1, 6 and 12 months.

Figure 1.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women

Characteristics	Variables	Categories	Total	Unemployed	Employed	p
			(N=1,031)	mothers (n=655)	mothers (n=376)
			n (%) or M±SD	n (%) or M±SD	n (%) or M±SD
Mother	Age (yr)	<30	327 (31.7)	235 (35.9)	92 (24.5)	<.001
		≥30	704 (68.3)	420 (64.1)	284 (75.5)
	Education	<University	306 (29.7)	235 (35.9)	71 (18.9)	<.001
		≥University graduate	725 (70.3)	420 (64.1)	305 (81.1)
	Infant feeding plan	Prior to pregnancy	648 (62.9)	434 (66.3)	214 (56.9)	.003
		After pregnancy	383 (37.1)	221 (33.7)	162 (43.1)
	BF education experience	No	324 (31.4)	195 (29.8)	129 (34.3)	.131
		Yes	707 (68.6)	460 (70.2)	247 (65.7)
	BF knowledge score		8.89±1.83	8.75±1.87	9.13±1.72	.001
Infant	Gender	Boy	529 (51.3)	335 (51.2)	194 (51.6)	.889
		Girl	502 (48.7)	320 (48.8)	182 (48.4)
	Birth order	1	656 (63.6)	402 (61.4)	254 (67.5)	.047
		≥2	375 (36.4)	253 (38.6)	122 (32.5)
	Having atopic dermatitis	No	785 (76.1)	500 (76.3)	285 (75.8)	.845
		Yes	246 (23.9)	155 (23.7)	91 (24.2)
Health-care	Delivery place	Private hospital	682 (66.1)	450 (68.7)	232 (61.7)	.022
		General hospital	349 (33.9)	205 (31.3)	144 (38.3)
	Delivery type	Vaginal delivery	676 (65.6)	423 (64.6)	253 (67.3)	.379
		Cesarean section	355 (34.4)	232 (35.4)	123 (32.7)
	Rooming-in	No	672 (65.2)	413 (63.0)	259 (68.9)	.059
		Yes	359 (34.8)	242 (37.0)	117 (31.1)
	BF during hospital stay	No	214 (20.8)	135 (20.6)	79 (21.0)	.879
		Yes	817 (79.2)	520 (79.4)	297 (79.0)

Variables	Categories	Total (N=1,031)			Unemployed mothers (n=655)			Employed mothers (n=376)
Variables	Categories	OR	95% CI	p	OR	95% CI	p	OR	95% CI	p
Mothers’ employment status	Not employed	1.00	0.59~1.70	.989
	Employed	1.00
Rooming-in	No	1.00	1.43~5.02	.002	1.00	1.25~5.74	.012	1.00	0.81~7.72	.109
	Yes	2.68			2.67			2.51
Atopic dermatitis of infant	No	1.00	1.16~4.99	.019	1.00	0.96~5.84	.060	1.00	0.62~7.98	.217
	Yes	2.40			2.37			2.23

Month	Variables	Categories	Total			Unemployed mothers			Employed mothers
Month	Variables	Categories	OR	95% CI	p	OR	95% CI	p	OR	95% CI	p
1 month	Mothers’ employment status	Unemployed	1.00	0.45~0.83	.001
		Employed	0.61
	BF during hospital stay	No	1.00	1.14~2.30	.007	1.00	1.35~3.28	.001	1.00	0.61~1.93	.795
		Yes	1.62			2.10			1.08
6 month	Mothers’ employment status	Unemployed	1.00	0.23~0.46	<.001
		Employed	0.33
	BF during hospital stay	No	1.00	1.18~2.64	.006	1.00	1.07~3.12	.026	1.00	0.93~3.28	.083
		Yes	1.77			1.83			1.75
	BF knowledge		1.13	1.03~1.23	.010	1.19	1.06~1.34	.004	1.04	0.91~1.20	.564
	Atopic dermatitis of infant	No	1.00	1.04~2.28	.031	1.00	0.92~2.61	.100	1.00	0.76~2.64	.276
		Yes	1.54			1.55			1.41
12 month	Mothers’ employment status	Unemployed	1.00	0.18~0.43	<.001
		Employed	0.28
	BF during hospital stay	No	1.00	1.15~3.37	.014	1.00	1.14~4.46	.020	1.00	0.70~4.34	.231
		Yes	1.97			2.25			1.75
	BF education experience	No	1.00	0.87~2.14	.178	1.00	0.56~1.86	.951	1.00	1.14~5.14	.021
		Yes	1.36			1.02			2.43
	Atopic dermatitis of infant	No	1.00	1.45~4.12	<.001	1.00	1.44~6.22	.003	1.00	0.78~4.07	.174
		Yes	2.44			2.99			1.78

Table 1. Characteristics of the Participants

BF=Breastfeeding.

Table 2. Adjusted Odds Ratios and Confidence Intervals for Breastfeeding Initiation by Multivariate Logistic Analysis*

All the variables in Table 1 except breastfeeding during hospital stay were included in the analysis and mothers’ employment status and the selected variables with significant association are presented.

Table 3. Adjusted Odds Ratios and Confidence Intervals for Breastfeeding Continuation by Multivariate Logistic Analysis*

All the variables in Table 1 were included in the analysis and the variables with significant association are presented; BF=Breastfeeding.