Trends in breastfeeding duration in Korea from 2007 to 2022 and implications for low-birth-weight infants: a repeated cross-sectional study

Abstract

Background: Breastfeeding provides essential health benefits to both infants and mothers and is strongly recommended for the particularly vulnerable group of low birth weight (LBW) infants. However, little is known about the breastfeeding trends among LBW infants in Korea. Therefore, this study aimed to investigate the breastfeeding trends among LBW infants in Korea from 2007 to 2022. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2022, we analyzed the trends in breastfeeding duration among Korean LBW infants. We analyzed trends in mean breastfeeding duration and the prevalence of exclusive breastfeeding at 3 and 6 months, examining associations with demographic variables using multivariable regression. We conducted a trend analysis using Joinpoint analysis and examined factors associated with breastfeeding duration using Cox proportional hazards regression. The study population comprised 4,080 children aged 12-48 months at the time of the survey, including 227 LBW infants. Results: The mean breastfeeding duration significantly decreased from 2015 to 2022, with an annual percentage change (APC) of -8.44% (P<0.05). The decline was more pronounced among LBW infants, whose mean breastfeeding duration consistently decreased from 2007 to 2022 (APC, -7.81%; P<0.05). LBW [hazard ratio (HR) =1.59; 95% confidence interval (CI): 1.50-1.69; P<0.001], and male sex (HR =1.11; 95% CI: 1.08-1.13; P<0.001) were associated with shorter breastfeeding duration, while urban residence (HR =0.91; 95% CI: 0.89-0.94; P<0.001) were associated with prolonged breastfeeding. Conclusions: Despite the several benefits of breastfeeding, its duration has been decreasing among Korean infants, with LBW infants experiencing particularly shorter durations. Stronger efforts are needed to support breastfeeding, particularly for this vulnerable group.