Literature review for - Flourish Paediatrics

Maternal education and breastfeeding outcomes
Search results
Data were extracted from 21 studies, including 16 prospective cohort studies, 1 retrospective
cohort study and 4 cross-sectional studies. Data from all studies were used to form the final
body of evidence statement, which included 9 studies of Australian women, 8 studies of
Chinese women, 3 UK studies and 1 study from New Zealand. Sufficient evidence was found
to make statements on the relationship between maternal education and breastfeeding
outcomes. Breastfeeding outcomes investigated included breastfeeding initiation/ at discharge
and breastfeeding duration.
What is the association between materal education and breastfeeding outcomes?
Draft Evidence statement
In Australia, and other Western countries, higher levels of
education are associated with better breastfeeding
outcomes. In Asian countries, such as China the reverse is
the case.
Draft Grade
C
Component Rating Notes
Evidence Base Good 17 prospective cohort studies (16P, 1 O), 1 retrospective
cohort study (P) 3 cross-sectional studies ( 1P, 2 O)
Consistency Satisfactory The direction of effect was different for Western and Asian
women
Clinical impact Good Substantial
Generalisability Excellent All studies involved either Australian women or women
from relevant population sub-groups
Applicability Satisfactory Studies of Chinese women not directly relevant to the
Australian healthcare context
Studies of women from Australia, New Zealand or the UK were considered separate to those
of Chinese women. Three prospective cohort studies reported that high level of maternal
education was positively associated with the initiation of breastfeeding and 4 prospective
cohort studies found no association with initiation. Four prospective cohort studies, 1
retrospective cohort study and 1 cross-sectional study found a positive association between
increased maternal education and breastfeeding duration. Three prospective cohort studies
reported no association with maternal education.
Amongst Chinese women 3 cohort studies and one cross-sectional study reported a negative
association between higher level of education and breastfeeding initiation and 3 cohort
studies reported a negative association with duration. One cohort study and one cross-
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