Advice from the obstetrician and other sources: Do they affect women's breast feeding practices? a study among different Jewish groups in Jerusalem

Breast feeding practices and the sources of advice that influenced them were studied in a sample of 276 women from North East Jerusalem. They were followed-up for 4 months and interviewed on 4 occasions during that period. It was found that 89.7% started breast feeding after parturition, 62.4% were breast feeding by 6 weeks, 40.3% were breast feeding after 3 months and 27.3% were still breast feeding by 4 months postpartum. Obstetrician's advice given at the 6 weeks postpartum examination was significantly associated with duration of breast feeding (P = 0.001). Other sources of guidance were not significantly related to duration of breast feeding when controlling for social class. Analysis of variance indicated that women of higher social classes breast fed more and for a longer period of time. There was no difference in the pattern of attendance at the obstetrician's examination by social class, although a very small proportion of women belonging to the lower social classes reported getting advice on breast feeding during that visit. There was a strong relation between advice of the obstetrician and percentage of women breast feeding at 4 months postpartum. Country of origin of the women also affected breast feeding practices. Women of Western origin breast fed more and longer than women of Asian or North African origin. This might be explained by social movements that attempt a return to more natural lifes styles which are prominent in Western societies. The differential relationship between advice of obstetrician and women belonging to different social classes is discussed and key elements in the relation between obstetrician's advice and women's breast feeding practices are considered.