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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

Copyright © 2015 Korean Society of Nursing Science

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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  • 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.
Figure 1.
Breastfeeding rate at initiation, 1, 6 and 12 months.
jkan-45-306f1.jpg
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)
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
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
    Image
    Figure 1. Breastfeeding rate at initiation, 1, 6 and 12 months.
    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)
    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
    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.


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