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The higher the portion of Catholics in a country, the lower the rates of breastfeeding, an ecological study found.

The breastfeeding rate was negatively correlated with the portion of Catholics in a western country (r=-0.30), and positively correlated with the portion of Protestants (r=0.36), reported , of Inserm, a research company in France, and colleagues.

But the negative correlation between breastfeeding and the portion of Catholics remained, even after adjusting for confounders such as gross domestic product per capita (r=-0.30) and Human Development Index -- a composite statistic of life expectancy, education, and per capita income indicators (r=-0.40), they wrote in

Overall, researchers examined data from 135 countries, but state-level data from five western countries only. By region, Central and South America had the largest portion of Catholics (average of 68%), while sub-Saharan African countries had the highest portion of Protestants (average of 32%).

The authors used Pew Research Centre database and the Central Intelligence Agency's World Fact Book to determine religion, and the online databases of the World Health Organization to determine rates of breastfeeding initiation.

Looking at state-level data from four out of five western countries, they found breastfeeding initiation was negatively correlated with the portion of Catholics, and positively correlated, in most instances, with the portion of Protestants:

• French Departments: Catholic (r=-0.31), Protestant (r=0.39).
• Irish counties: Catholic (r=-0.34), Protestant (r=0.02).
• England, Wales, Scotland, N. Ireland: Catholic (r=-0.78), Protestant (r=0.53).
• Canadian provinces: Catholic (r=-0.58), Protestant (r=-0.34).

The numbers in the U.S. were slightly less clear. Overall, state-level data found breastfeeding positively correlated with the portion of Catholics in a state (r=0.26), and negatively correlated with the number of Protestants (r=-0.65). After adjusting for education and socioeconomic status, there was almost no correlation between breastfeeding and the portion of Catholics (r=0.06), and the negative correlation between breastfeeding and the number of Protestants was slightly attenuated (r=-0.30).

Interestingly, various popes and high-ranking members of the Catholic church have endorsed the practice of breastfeeding since as far back as Pope Francis also on the issue in 2014, saying that women should even be allowed to breastfeed in church. In addition, the currently offersto a book about breastfeeding as a method of natural child spacing.

The authors had several history-based hypotheses for the religious divide. They cited that indicated European Catholic mothers were less likely to breastfeed than Protestant mothers as far back as the 16th and 17th centuries. Researchers also referenced on historical breastfeeding indicating that sex and lactation "were judged incompatible by the Catholic church, with predictable consequences on breastfeeding rates in Catholic households." found that the Catholic ethic tended to adopt a more skeptical attitude about novel things, and could be less adaptable and dynamic when faced with new scientific recommendations such as breastfeeding, the authors wrote.

But they also argued that this was an ecological, not an individual-level study -- as individual-level data may either confirm or refute their findings. They characterized these results as "a new population-level factor," and another way to identify potential sociocultural values that may have an impact on women's breastfeeding attitudes. Currently, religion is not considered a determinant of breastfeeding practices.

"This observation may help policymakers and healthcare professionals target at-risk populations and reinforce or adapt their breast feeding promotional efforts according to sociocultural background," they noted.

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