This publication provides information on breastfeeding practices in Australia. The information is sourced from the 2001 National Health Survey (NHS), conducted during the 10 month period February to November 2001. It is the third in a series of regular population surveys designed to obtain national benchmark information on a range of health-related issues and to enable the monitoring of trends in health over time.
The 2001 NHS aimed to collect information about the health status of Australians, their use of health services and facilities and health-related aspects of their lifestyle. Previous surveys in the series were conducted in 1989-90 and 1995.
The estimates contained in this paper are based on information obtained from residents of a sample of private dwellings (houses, flats etc.) and from some types of non-private dwellings (hotels, motels, and boarding houses). Other special dwellings, such as hospitals, nursing homes and prisons were excluded from the survey.
In total, 17,918 household were included in the sample. Certain groups of persons such as non-Australian diplomatic personnel, persons from overseas holidaying in Australia, members of non-Australian defence forces and their dependants stationed in Australia, and students at boarding schools were excluded from the survey.
Information was collected for all children aged 0–3 years in scope of the survey.
Questions on breastfeeding were asked in respect of children aged three years and under at the time of the survey. For most children, questions were answered by a parent on their behalf, usually the mother (83%). Questions were asked to establish whether the child had ever been breastfed or was currently being breastfed.
For children ever breastfed, information was collected to determine if foods other than breastmilk had been introduced into the diet and at what age regular cnsumption of these had started. These foods were infant formula, cow’s milk, other milk substitutes (soya bean milk, goat's milk, evaporated milk, other milk), and solid food. For those children previously but not currently breastfed, the main reason for stopping breastfeeding was also collected.
For those children who had never been breastfed, the same series of questions were used to establish the type of food (other than breastmilk) the child was initially given, and the age at which other foods had been introduced (if at all). "Introduced" was defined as when first started consuming the food on a regular basis, as opposed to when first offered.
Data presented in graph 1 have been modelled using the ever breastfed data item to show breastfeeding rates for children aged 0 to 3 years. The rates have been produced through application of a lifetable method which uses the breastfeeding history of the children that have passed the age in question, as well as the ones at that current age. This results in a sample that is considerably larger than children at the particular age at the time of interview.
Items collected by the survey include:
- breastfeeding status;
- whether breastfed when came home from hospital;
- whether ever regularly given -
cow's milk; and
other milk substitutes;
solid food (if under 6 months of age);
- age (months) first given regularly -
other milk substitutes; and
- type(s) of milk substitutes;
- main reason for stopping breastfeeding;
- age (months) first regularly given anything other than breastmilk;
- type of product first given;
- age (months) first given breastmilk substitute;
- type of substitute given;
- total time breastfed;
- total time fully breastfed.
Points to be considered in interpreting data on breastfeeding:
- Information is ‘as reported’ by respondents. Results based on mothers recall (e.g., age of child when first regularly consumed solids) should be interpreted with caution as accuracy of recall may decline as the child gets older.
- Respondents may have interpreted the concept of "regular" inconsistently where they did not seek clarification from the interviewer. The concept of regular consumption, used by NHS breastfeeding questions, was not defined by specific consumption patterns (e.g. daily intake). Therefore this concept may have been open to interpretation by the respondent, and should be taken into consideration when interpreting results.
- The accuracy of the data may be reduced in cases where an adult other than the child’s mother responded for the child. This occurred for around 17% of children aged 0 - 3 years.
- Issues relating to the benefits of breastfeeding have been widely promoted in the community and some respondents may have tended to report recommended practices rather than actual practices.
- Data from this survey cannot be compiled using the concepts of "exclusively breastfed" or "predominantly breastfed" which have been recently adopted for national monitoring purposes. Concepts of breastfeeding status were instead defined around the notion of other foods being introduced on a regular basis into the diet of a child. Thus, the classes of breastfeeding status developed from the NHS were fully breastfed (receiving only breastmilk on a regular basis), partially breastfed (breastfed and receiving regular breastmilk substitutes but no solids on a regular basis), complementary breastfeeding (breastfed and receiving solids on a regular basis, with or without other breastmilk substitutes), and, not breastfed.
Table A summarises these concepts and compares them to the classification system used by the World Health Organization (WHO).
Table A - Definitions of breastfeeding: ABS vs WHO classifications
||ABS classification||WHO classification|
Breast milk only (may also [only] have: drops, syrups, medicines, vitamins & minerals)
(does not measure consumption of juice, syrups, water, vitamins or minerals)
(measures consumption of juice, syrups, water, vitamins and/or minerals)
Breast milk and other liquids (may also have other liquids except non-human milks or food-based fluids)
Breast milk, non-human milk and/or \
Breast milk and solid or semi-solid foods
||Not breastfed||Not breastfed|
Respondents in the NHS were asked about their alcohol consumption in the last seven days prior to the survey. They were classified to an alcohol risk level based on their reported average daily consumption. Women were classified to low, risky and high risk levels on the basis of <25ml, 25-50 ml and >50 ml of alcohol consumption per day, respectively.
Comparability with 1995
The methodology and questions used in the 2001 NHS were the same as those used in the 1995 survey, and therefore data are available which are considered directly comparable between surveys. However care should be taken to ensure consistent definitions (eg. breastfeeding status) have been used in compiling the particular estimates being compared.
Commonwealth Department of Health and Ageing (2003). Australian Alcohol Guidelines. Commonwealth of Australia, Department of Health and Ageing, Population Health Division, Canberra.
Commonwealth Department of Health and Ageing (2002). Annual report of the Advisory Panel on the Marketing in Australia of Infant Formula, July 2000 - June 2001, Commonwealth of Australia, Canberra.
Marks, G.C., Rutihauser, I.H.E., Webb, K. and Picton, P. (2001). Key Food and Nutrition Data for Australia 1990 - 1999. Commonwealth Department of Health and Aged Care, Australian Food and Nutrition Monitoring Unit, Canberra.
National Health and Medical Research Council (2003). The Dietary Guidelines for Children and Adolescents in Australia incorporating the Infant Feeding Guidelines for Health Workers. Commonwealth of Australia, Canberra.
Nursing Mothers' Association of Australia (1995). Prevalence and Duration of Breastfeeding in Australia. data sheet, Victoria.
Nutbeam, D., Wise, M., Bauman, A., Harris, E.and Leeder, S. (1993). Goals and Targets for Australia's Health in the Year 2000 and Beyond. Department of Public health, University of Sydney, a report prepared for the Commonwealth Department of Health, Housing and Community Services, Canberra.
Trusell, J., Grummer-Strawn, L., Rodriguez,G. and Vanlandingham,M. (1992). Trends and Differentials in Breastfeeding Behaviour: Evidence from the WFS and DHS. Population Studies, no. 46, pp 285-307.
World Health Organization (2001). The Optimal Duration of Exclusive Breastfeeding. Results of a WHO systematic review. Geneva:WHO, April 2001.
Australian Breastfeeding Association 2003. www.breastfeeding.asn.au (last viewed 1/9/03).