Breastfeeding Practices and Parental Employment in Japan

Miki Kobayashi, Kobe Universityand

Emiko Usui, Hitotsubashi University

forthcoming, Review and Economics of the Household20th International Panel Data Conference Tokyo, July 9-10, 2014

Objective of This Paper

Few data on breastfeeding in Japan

Japanese Longitudinal Survey on Employment and Fertility (LOSEF)• Survey conducted in 2012

– Info on breastfeeding initiation and duration for each child and each mother– Info on mothers’ and fathers’ change in employment status and job

responsibilities 1 year before and after childbirth

Advantages1. Estimate mother fixed-effects model2. Study the relationship between fathers’ & mothers’ work

arrangements and breastfeeding practices

BACKGROUND

Benefits of BreastfeedingFor Children Protection against childhood infectious diseases Decreased risk for chronic diseases and sudden infant death

syndrome Positive association with higher intelligence scores Reduced risk for being overweight or obese later on

For Mothers Reduced postpartum bleeding Delays in the resumption of menstrual cycle Faster shrinking of the uterus Decreased risk of breast and ovarian cancers

Source：American Academy of Pediatrics (2005, 2012)

WHO/UNICEF, 1990

World Health Organization (WHO) and UNICEF recommend:

1. Exclusive breastfeeding for the first 6 months2. Continued breastfeeding for 2 years or more

Breastfeeding Ratio by Infant’s Age: U.S.-Japan Comparison

0

10

20

30

40

50

60

70

80

90

100

0 month old 1 month old 2 month old 3 month old 4 month old 5 month old 6 month old

%

Infant’s Age

Source： CDC National Immunization Survey MLHW National Nutrition Survey on Infants and Preschool Children

Japan：Any Breastfeeding

U.S.：Any Breastfeeding

Japan：Exclusive Breastfeeding

U.S.：Exclusive Breastfeeding

Japan（2005）U.S.（2010）

Breastfeeding and Maternal Employment

• Many studies find evidence of incompatibility between maternal employment and breastfeeding

– U.S. … Return to work within 3 months after childbirth, breastfeeding initiation decreases by 16-18% and breastfeeding duration is shortened by 4-5 weeks (Chatterji and Frick, 2005)

– Canada … every additional month not at work after childbirth, breastfeeding duration increases by 2.6 weeks (Baker and Mulligan, 2008)

– Roe et al. (1999), Haider et al.(2003), Mandal et al.(2010,2012) for the U.S. Gatrell (2007) for the UK, Cooklin et al.(2008) for Australia

• How about Japan?

National Surveys on Breastfeeding in Japan

1. National Nutrition Survey on Infants and Preschool Children2. National Growth Survey on Infants and Preschool Children3. Longitudinal Survey of Babies in Twenty-first Century

Drawbacks:• Don’t have info on family background characteristics → (1) (2)

– parents’ education and employment status, # of children in household → (1)– parents’ education and fathers’ employment status → (2)

• BF info only on the youngest child at 6 months of age → (3)⇒

• Cannot study the association between maternal and paternal employment and breastfeeding practices

Advantages of LOSEF Data

Japanese Longitudinal Survey on Employment and Fertility (LOSEF)• Survey conducted in 2012• Info on breastfeeding initiation and duration for each child and each

mother; info on mothers’ education• Info on mothers’ and fathers’ change in employment status and job

responsibilities 1 year before and after childbirth

Advantages1. Estimate mother fixed-effects model2. Study the relationship between fathers’ & mothers’ work

arrangements and breastfeeding practices

LOSEF DATA

LOSEF Data• Japanese Longitudinal Survey on Employment and Fertility (LOSEF)

– Project of the Economic Analysis of Intergenerational Issues – Funded by a Grant-in-Aid for Specially Promoted Research from Japan’s

Ministry of Education, Culture, Sports, Science and Technology– Principal Investigator: Noriyuki Takayama

• Sample:– Men and women, 20-49 years of age

• Pilot survey (February 2012) and First survey (September and October 2012)

• Total sample size: 6,901

• Second survey will be conducted in Fall 2014

Measures on breastfeeding practices

Breastfeeding initiation“Did you breastfeed your child?”

Yes = 1No = 0

Breastfeeding durationIf “Yes”,Until when did you (or your spouse) breastfeed your child? Includes exclusive breastfeeding and mixed feeding

Recollection data for all children

Child, Mother, and Father Characteristics

Child’s characteristics:• sex, low-birth-weight, multiples, firstborn, # of siblingsMaternal characteristics:• age at birth of child, education, birth cohortMother’s change in employment status 1 yr. before and after childbirth:• not employed before or after, left employment, employed before and

returned to work, started workingFather’s change in job responsibility 1 yr. before and after childbirth:• more responsibility, work under flextime system, more hours for pay

at home, travel less for work, no change, other, not working

LOSEF: Number of months of breastfeeding

0

5

10

15

20

25

30

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 3637

 or m

ore

(%)

Data source: LOSEF

86.1% initiate breastfeeding

WHO

ESTIMATION RESULTS:

Breastfeeding initiation

95% CI 95% CIMultiple Birth 0.382 *** (0.209-0.699) 0.095 * (0.006-1.572)Low Birth-weight 0.662 *** (0.500-0.877) 0.331 ** (0.122-0.900)Female Child 0.982 (0.850-1.136) 1.351 (0.921-1.981)Child is First Born 1.036 (0.908-1.182) 0.837 (0.504-1.391)Two Children 1.413 *** (1.097-1.819)More than Three Children 1.765 *** (1.300-2.394)Mother's Age 1.062 *** (1.036-1.089) 1.121 ** (1.004-1.251)Less than High School 0.634 * (0.375-1.071)Junior College 1.586 *** (1.268-1.983)More than College Education 2.149 *** (1.549-2.982)

Mother's Change in Employment StatusNot Employed Before or After 0.715 ** (0.538-0.949) 0.479 (0.195-1.179)Employed, Returned to Work 0.894 (0.632-1.266) 0.716 (0.196-2.609)Started Working 1.006 (0.618-1.637) 0.949 (0.135-6.673)

Father's Change in Job ResponsibilityWork Under Flextime System 11.21 *** (2.809-44.75)More Hours for Pay at Home 1.459 (0.546-3.897)Travel Less for Work 1.077 (0.434-2.670)N 4986420

Logit Fixed-Effect LogitOdds ratios Odds

Duration of Breastfeeding

S.E. S.E.Multiple Birth -2.532 ** 1.025 -2.757 ** 1.408Low Birth-weight -0.617 0.546 0.185 0.489Female Child 0.049 0.259 -0.127 0.214Child is First Born 0.820 *** 0.252 0.632 ** 0.278Two Children 1.731 *** 0.442More than Three Children 1.635 *** 0.548Mother's Age 0.271 *** 0.044 0.265 *** 0.064Less than High School -1.669 1.345Junior College -0.417 0.418More than College Education 0.352 0.482

Mother's Change in Employment StatusNot Employed Before or After -0.060 0.518 -0.406 0.577Employed, Returned to Work -0.152 0.632 -1.654 * 0.903Started Working -0.291 1.028 -0.990 0.935

Father's Change in Job ResponsibilityWork Under Flextime System 0.227 1.071 4.418 ** 1.805More Hours for Pay at Home 2.317 1.811 -0.153 1.751Travel Less for Work -1.230 1.598 -0.898 1.663N 5041 5041

OLS Fixed EffectCoef. Coef.

Summary of Estimation Results

Mother:Compared to mothers who leave their jobs after childbirth, mothers who return to work within a year after childbirth do not differ in breastfeeding initiation, but breastfeeding duration is shorter by 1.6 months

Father:When fathers work under a flextime system after childbirth, breastfeeding initiation is higher, and the duration is longer by 4.4 months.

Additional findingMothers’ education:Breastfeeding tends to be initiated by mothers with a higher level of education, but once initiated, breastfeeding duration does not differ significantly by mothers’ education

Firstborn child:Breastfeeding initiation does not differ by the child’s birth order, but its duration tends to be longer for the firstborn child than younger ones

Breastfeeding initiation and duration are greater…give birth to a singleton, mothers from later generations, mothers give birth to a child at an older age

Conclusion

• Key finding– Fathers work under a flextime system after childbirth,

breastfeeding initiation is higher, and the duration is longer– Letting fathers work under a flextime system would help

promote breastfeeding practices in Japan.

• Policy implication– Only 1.89% of the male labor force takes paternity leave (2012)– Flextime system is less costly and more easily adoptable for both

the firm and the worker.– Flextime system may be a more realistic option for supporting

working families in Japan

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