Prevalence and Factors Affecting Breastfeeding Among Aboriginal Women in Northwestern Ontario

Abstract

To evaluate breastfeeding outcomes among Aboriginal women and to determine variables affecting breastfeeding in the early postpartum period. Prospective cohort study. Two sites in Northwestern Ontario, Canada: a tertiary care center and a rural hospital. One hundred thirty breastfeeding Aboriginal women agreed to participate in the study. All women completed a baseline survey in hospital that included questions regarding demographic, prenatal, breastfeeding, obstetric, postpartum, and neonatal characteristics. Women were then telephoned at 4 and 8weeks postpartum to complete additional questionnaires regarding infant feeding. Low rates of breastfeeding initiation (69%) and exclusive breastfeeding were identified at 4 (37.5%) and 8 (35.3%) weeks postpartum. Among those who initiated breastfeeding, duration rates at 4 (86%) and 8weeks (78%) postpartum are comparable to other studies. Variables associated with any and exclusive breastfeeding at 8weeks included the following: (a) household income, (b) intended breastfeeding duration, (c) plan to exclusively breastfeed, (d) perception of meeting their planned duration goal, and (e) higher breastfeeding self-efficacy. Partner support was associated with any breastfeeding at 8weeks but not exclusivity. Women who were breastfeeding exclusively in hospital (prevalence ratio [PR]=.48, 95% confidence interval [CI][0.27, 0.86]), did not smoke (PR=2.5, 95% CI[1.4, 4.3]) and/or use substances during pregnancy (PR=4.5, 95% CI[1.5, 14]) were more likely to be breastfeeding exclusively at 8weeks. Many of the variables may be considered modifiable and amenable to intervention. Targeted interventions should be directed toward improving breastfeeding outcomes among Aboriginal women.