This is an illustrative example of social inequalities - how breastfeeding rates vary by socioeconomic/-demographic factors in the UK.

What do you think about it?

My personal thoughts - the neonatal community need to be aware and take this into account when counseling etc, but (IMHO) this boils down political strategies how to overcome societal gaps (so a difficult perspective!)

And (again IMHO), this is not UK-specific results, they are probably generalizable to most context (Sweden, for sure!)

ADC Fetal & Neonatal Edition

Association between maternal sociodemographic characteris...

Objective To ascertain the sociodemographic and geographical determinants of exclusive and no mother’s own milk (MOM) feeding for infants <34 weeks’ gestational age (GA) in England and Wales. Stud...

The relationship between breastfeeding and infant health has been extensively studied, with increasing evidence highlighting the influence of social determinants on breastfeeding practices. The findings of Ryan et al (2025) align with a longstanding body of research demonstrating that socioeconomic factors shape maternal and child health outcomes.

Notably, Cesar Victora, a Brazilian epidemiologist, was a pioneer in this field, leading the first epidemiological study to establish a direct link between breastfeeding and the prevention of infant mortality. His research also reinforced that nutritional interventions within the first thousand days of life—spanning pregnancy to two years of age—yield far greater benefits than interventions introduced later in childhood. As he emphasized, investing in early nutrition is a cost-effective strategy to improve both immediate health outcomes and long-term human capital.

Furthermore, Victora’s work played a foundational role in shaping global breastfeeding policies, including the World Health Organization’s (WHO) 1991 recommendations on exclusive breastfeeding. His studies demonstrated that exclusive breastfeeding contributes to improved cognitive development, higher educational attainment, and greater earning potential later in life—further reinforcing the long-term impact of early-life nutrition.

Crucially, Victora also advanced research into the social determinants of health. His early work revealed that children living on smallholdings, where income distribution was more equitable and families had land ownership, exhibited better health outcomes compared to those from large estates. This insight underscored how structural inequalities influence child health, including breastfeeding practices. The current study by Ryan et al (2025) extends this line of inquiry, further demonstrating that breastfeeding is not only a biological process but also a socially determined behavior, shaped by economic, educational, and healthcare access factors. Victora’s contributions remain highly relevant in contemporary discussions on how to address these disparities and promote breastfeeding as a fundamental public health strategy. His book, “Epidemiology of Inequality”, published in 1988 should be a must read for all professionals involved in child health.

Many thanks @Mariana Oliveira , while I have the same vague idea about breast feeding benefits as most NICU staff (and the social determinants thereof!) I admit I was not aware about Cesar Victoria. While googling for his book, the first google hit was the Wikipedia article about his carrier (https://en.wikipedia.org/wiki/Cesar_Victora

One thought that popped up… while most of know that ”breast is best”, there is a bit of learning when it comes to both basics and details about the actual data supporting that statement. Maybe we could make some educational activity ?

I would love to do that. In any format you wish. Cesar Victora’s work is an inspiration for my daily practice in the NICU.