Breastfeeding and infants' time use
This section is an edited extract from Baxter, J & Smith, J 2009 Breastfeeding and infants' time use, Australian Institute of Family Studies Research Paper no. 43, June 2009.
Being breastfed during infancy contributes to a child's nutrition, health and development. Expert guidelines for optimal infant feeding recommend that infants be exclusively breastfed for the first six months of life and, along with appropriate complementary foods, continue to be breastfed for up to two years and beyond. However, the reasons why breastfeeding is associated with improved developmental outcomes remain poorly understood. Breast milk is known to be important for brain development. In addition, breastfeeding may also co-occur with other early life experiences that are related to improved child wellbeing, for example, higher levels of maternal education. One possible, yet previously unexplored, explanation is that the days of breastfed infants are different to those not breastfed, such that breastfed infants are exposed to activities or contexts that may enhance their outcomes. Time use research provides a potentially useful tool for investigation of this issue.
This analysis uses data from Growing up in Australia: the Longitudinal Study of Australian Children, Wave 1 (2004) B cohort. The total infant cohort available for analysis comprised 5,045 infants aged 3 to 14 months (a small number aged over 14 months were excluded). Breastfeeding status was derived from mothers' reports, with 43 per cent of infants reported to be breastfeeding at the time that children's activities were recorded in time use diaries.
Parents were asked to report on their infant's time use by completing a diary for one weekday and one weekend day, on pre-specified dates. In the diary, each day is divided into 15 minute intervals, and parents mark infants' activities and the contexts in which the activities took place against the lists provided. Table 6 and Table 7 illustrate how these activities and contexts are used in this paper. Diaries were excluded if they had too much missing data, and only those children with two valid diaries were included, so that the weekday and weekend data could be combined to derive a weekly estimate of time spent in each activity. The number of children who met these criteria was 2,878. From the derived weekly data for these children, an average daily estimate of time in each activity was calculated, and these data form the basis of the findings reported.
Table 6 shows the percentage of infants who had engaged in the activity (on left), and the average amount of time spent on the activity by children who had engaged in it (on right). Not surprisingly, all or almost all infants were reported to spend time sleeping/napping, being bathed, having their nappy changed or other personal care. Activities that were less common were:
- organised activities, playgroup (19 per cent),
- colour/draw, look at a book, puzzles (26 per cent)
- breastfeeding (41 per cent).
The activities on which most time was spent were:
- sleeping, napping (on average 821 minutes per day)
- held, cuddled, comforted, soothed (on average 144 minutes per day)
- crawl, climb, swing arms/legs (160 minutes)
- other play, other activities (163 minutes)
- other eating, drinking or feeding (137 minutes)
- breastfeeding infants, breastfeeding (128 minutes).
| Percentage of infants who did the activity % | Average daily duration on activity (SD) Minutes | |
|---|---|---|
| Sleeping, napping | 100 | 821 (107) |
| Awake in bed/cot | 87 | 55 (54) |
| Bathe/nappy change, dress, hair care | 99 | 94 (44) |
| Breastfeeding | 41 | 128 (72) |
| Other eating, drinking or feeding | 98 | 137 (60) |
| Held, cuddled, comforted, soothed | 96 | 144 (119) |
| Crying/upset | 82 | 54 (52) |
| Destroy things, create mess | 40 | 52 (69) |
| Crawl, climb, swing arms/legs | 80 | 160 (124) |
| Read a story, talked/sung to | 73 | 121 (135) |
| Colour/draw, look at book, puzzles | 26 | 31 (37) |
| Watch TV, video or DVD | 59 | 61 (61) |
| Organised activities, playgroup | 19 | 54 (73) |
| Other play, other activities | 91 | 163 (109) |
Note: Activity duration is reported only for those who spent some time in this activity.
SD=Standard deviation.
Looking next at the contexts in which infants' activities took place (see Table 7), the people that infants were with during these activities is examined. For these analyses, the daily estimates are limited to times that infants were awake. Almost all infants (96 per cent) spent some time with their mother, and 93 per cent spent time with mothers when fathers were not present. A great majority of infants spent time with their father (89 per cent), but only 56 per cent spent time with their fathers only, when mothers were not there. Over half the infants spent some time with a grandparent or other adult relative, while only 13 per cent spent some time in child care.
| Awake and with ... | Percentage of infants % | Average duration (SD) Minutes |
|---|---|---|
| Mother (others may have been present) | 96 | 510 (146) |
| Mother when father was not present | 93 | 314 (150) |
| Father (others may have been present) | 89 | 255 (140) |
| Father when mother was not present | 56 | 59 (68) |
| Grandparents or other adult relatives | 55 | 133 (130) |
| In child care | 13 | 88 (119) |
Note: Duration is reported only for those who spent some time in this context.
SD=Standard deviation.
Further analyses examined the factors related to differences in the amounts of time infants spent on particular activities or in different contexts. The analyses presented here focused on whether differences between breastfed and non-breastfed infants were evident when other characteristics were included. Characteristics taken into account were child age, birth order and sex, maternal age, education, hours worked, Indigenous status, country of birth, whether mothers smoked, fathers' employment status, parental income and whether a grandparent lived in the home.
These analyses enabled estimates to be calculated of the predicted amount of time spent on activities by infants who were, or were not, breastfed.1 The predicted amount of time infants spent on selected activities is shown in Figure 9 and in selected contexts in Figure 10.
The results show that breastfed infants spent on average 32 minutes more per day being held, cuddled or soothed (157 minutes for breastfed compared with 125 minutes for non-breastfed infants), 5 minutes more crying or upset; and 27 minutes more being read, talked or sung to (Figure 9).
Figure 9: Infants' activities: predicted minutes per day on selected activities by breastfeeding status
Note: I--I indicate 95 per cent confidence intervals.
Breastfed infants spent on average 54 minutes less per day on other eating, drinking or being fed activities (101 minutes for breastfed infants and 156 minutes for non-breastfed infants); 9 minutes less per day watching television; and 40 minutes less per day sleeping or napping (Figure 9).
Being breastfed was not related to the amount of time spent on the following other activities: destroy things, create mess, crawl, climb, swing arms/legs, colour, draw, looks at book, puzzles, organised activities/playgroup or other play.
Summing up, on the positive side, breastfeeding was associated with more time being cuddled/comforted/soothed; read/talked/sung to; and less television watching, but also on the less positive side, less time sleeping/napping and more time crying or upset.
There were also significant differences by age of the child (for example, older infants spent less time sleeping and being cuddled/comforted/soothed and more time doing other play) but there were almost no differences by sex. Firstborn children were read, talked or sung to more, and spent more time doing various play-type activities. Children of older mothers and more highly educated mothers were read, talked or sung to more. Children of more highly educated mothers also watched less television.
Looking at how infants' contexts varied according to whether or not they were breastfed, those still breastfeeding spent more time, on average with their mother (57 minutes more per day, Figure 10), and fathers (15 minutes more per day, Figure 10). Time with mother was largely time alone with mother (45 out of the 57 minutes extra for breastfed children), while the difference in time with father corresponded more to time that mothers and fathers were together (for 12 of the 15 minutes of extra father-time for breastfed children, the mother was also present).
The amount of time spent in child care or with grandparents or other adult relatives was not significantly related to whether an infant was still breastfed.
Other characteristics associated with differences in time infants spent in different contexts centred on parents' work commitments (work hours for mothers and employment status for fathers).
Figure 10: Infants' time with mother and with father: predicted minutes per day by breastfeeding status
Note: I--I indicate 95 per cent confidence intervals.
Conclusion
The findings reveal differences in the time spent by breastfeeding infants on various activities compared with non-breastfed infants of comparable age and other relevant characteristics. These findings show that time use data can provide valuable information on possible pathways to development for infants and young children.
- Predicted values are based on Ordinary Least Squares (OLS) analyses, with all other characteristics set at their mean values.