Factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women: a multi-centre study.

Rishma Chooniedass,Heidi Sze Lok Fan,Stephanie Masina,Padmaja Subbarao,Stuart E Turvey,Meghan B Azad,Sarah Turner,Piushkumar Mandhane,Theo Moraes,Katie Del Buono,Marie Tarrant,Allan B Becker,Malcolm R Sears

doi:10.1017/s1368980021004699

Abstract

To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women. Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. General community setting in four Canadian provinces. In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012. Of 3010 participants included in the current study, the majority were Canadian-born (75·5 %). Breast-feeding initiation rates were high in both non-Canadian-born (95·5 %) and Canadian-born participants (92·7 %). The median breast-feeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breast-feeding initiation and continuation were older maternal age, higher maternal education, living with their partner and recruitment site. Rooming-in during the hospital stay was also associated with higher rates of breast-feeding initiation, but not continuation at 6-month postpartum. Factors associated with non-initiation of breast-feeding and cessation at 6-month postpartum were maternal smoking, living with a current smoker, caesarean birth and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breast-feeding initiation and lower odds of breast-feeding continuation at 6 months, and older maternal age and recruitment site were associated with breast-feeding continuation at 6 months. Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breast-feeding initiation rates, breast-feeding initiation and continuation are more strongly associated with socio-demographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breast-feeding continuation in both groups and may indicate geographic disparities in breast-feeding rates nationally.

Highlights

MethodsDesign, setting and participants We accessed data from the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study, a multicenter national birth cohort study that recruited pregnant women from four Canadian provinces
Study variables Breast-feeding initiation was recorded in the postpartum period on the hospital records and was extracted by the study research staff
We found no association between any of the assessed migration characteristics and breast-feeding initiation or breast-feeding continuation at 6-month postpartum in non-Canadian-born participants, power was limited for the current analysis

Summary

Methods

Design, setting and participants We accessed data from the CHILD Cohort Study, a multicenter national birth cohort study that recruited pregnant women from four Canadian provinces. From 2008 to 2012, the study recruited 3621 participants in their second and third trimester, and prospective follow-up is still ongoing[25]. At the time of the study, only one recruitment site was designated as a Baby-Friendly Hospital[26]. The present analysis excluded participants from the Vanguard cohort and only focused on the general cohort of 3405 participants (see Fig. 1). Seventy-seven infants were ineligible at or before birth, 64 mothers subsequently withdrew and 254 were missing relevant breast-feeding data. Complete baseline and breast-feeding initiation data were available for 3010 participants. There was a small loss to follow-up (n 104) with 6-month breast-feeding status was available for 2906 of these participants.

Results

Discussion

Conclusion