Family Policies and Public Health Initiatives: A Comparative Analysis of Breastfeeding Outcomes

Abstract

Breastfeeding rates vary considerably among high-income countries who are members of the Organization for Economic Co-operation and Development (OECD). In the 1960's, breastfeeding outcomes, both initiation of breastfeeding and breastfeeding duration, were at an all-time low. Over the past half century, breastfeeding outcomes have increased among all OECD countries, but at very different rates. This dissertation examines both the policy-level and public health-level initiatives that have affected the differential growth of breastfeeding rates among 18 high-income, OECD countries. Using a combination of multiple regression, fuzzy-set qualitative comparative analysis, and small-n methods, I find that countries in the broad Scandinavian welfare regime have combined policy support for women's reproductive and productive labor, along with a strong female representation in government to facilitate positive breastfeeding outcomes. I find that countries who have a strong commitment to the World Health Organization's Baby-Friendly Hospital Initiative have higher breastfeeding initiation rates than countries who do not have a high percentage of hospitals following the WHO protocol. This dissertation adds to the broader understanding of how welfare state policies and public health initiatives operate in tandem to support positive breastfeeding outcomes among high-income countries.