Impact of working status on breastfeeding in Singapore - Evidence from the National Breastfeeding Survey 2001

Background: This study uses data from the 2001 Singapore National Breastfeeding Survey to examine factors, including working status, associated with breastfeeding duration. Methods: All women who delivered in the eight hospitals with obstetric services in Singapore from 1 April to 31 May 2001 were invited to participate in a survey on infant feeding and nutrition at 2 and 6 months postpartum. A total of 2149 respondents were interviewed for variables that were known or suspected to be associated with breastfeeding initiation and duration. Cox proportional hazards model was used to determine the associated effect of working status on breastfeeding duration. Kaplan-Meier estimate and survival curves were compared between working and non-working mothers. Results: Working status had no effect on initiation of breastfeeding, but had an effect on breastfeeding duration. The median breastfeeding duration for non-working and working mothers was 9 weeks and 8 weeks, respectively. This difference was significant by log rank test [hazard ratio (HR) 1.27, 95% confidence interval (CI) 1.14-1.41, P value < 0.001]. About 31% of non-working mothers breastfed for up to 6 months as compared to 20% of working mothers. Working mothers were more likely to stop breastfeeding than non-working mothers (HR 1.61, 95% CI 1.43-1.85, P value 0.001) after adjusting for potential confounders. The most important reason for working mothers stopping breastfeeding between 2 and 6 months was attributable to work. Conclusion: More breastfeeding-friendly initiatives need to be put in place at workplaces to encourage working mothers to continue breastfeeding upon returning to work.