Breastfeeding is well-established as optimal for both mother and baby, with a number of benefits including a quicker return to pre-pregnancy weight for the mother and the reduced risk of non-communicable diseases, including obesity, for the infant. The current global recommendation is to breastfeed exclusively for 6 months postpartum, yet in Ireland initiation and duration of breastfeeding is extremely low. Low education level is considered a barrier to breastfeeding, however, there is currently a paucity of research on the influence of maternal well-being on breastfeeding habits in Ireland.

To explore the relationship between education levels and well-being in early pregnancy on breastfeeding habits in Irish women.

This was a secondary analysis of the randomised control trial, the ROLO study in the National Maternity Hospital, Dublin, Ireland. 610 healthy, pregnant women on their 2nd pregnancy were included. Well-being was measured using the WHO-5 item well-being index at the end of the 1st trimester. Education level and breastfeeding initiation information were both obtained from hospital records. Women were stratified into two groups of education level; those that had achieved 3rd level education (n = 341), and those with less than 3rd level (n = 269). Within these two groups, the relationship between well-being scores and breastfeeding habits was explored using Pearson correlations, chi-square tests, and multiple regression modelling for confounders.

In Women with high education, those with high well-being (n = 269) were significantly more likely to initiate breastfeeding than those low well-being (n = 72; 69.5% vs 56.9%, p < 0.05). This association remained after controlling for maternal age, BMI, and intervention group (B = 0.57, p < 0.05). Well-being was not associated with breastfeeding duration in women with 3rd level education (26.63 weeks vs 25.64 weeks, p = 0.87). In women with low education levels, there was no association of well-being and breastfeeding initiation (37.4% vs 35.9%, p = 0.84) or well-being and breastfeeding duration (6.75 weeks vs 5.70 weeks, p = 0.65).

While education level is a strong indication of women's likelihood to breastfeed, it is important to recognise other influencing factors. Among highly educated women well-being was also important as a determinant of initiating breastfeeding. This is important for healthcare professionals working in maternity care in Ireland and highlights the potential of improving well-being and there-by increasing Irish breastfeeding rates.