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

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

doi:10.1017/S1368980021004699

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

Public Health Nutr. 2021 Dec 3;25(10):1-12. doi: 10.1017/S1368980021004699. Online ahead of print.

Authors

Rishma Chooniedass^{1

2}, Marie Tarrant¹, Sarah Turner^{3

2}, Heidi Sze Lok Fan⁴, Katie Del Buono¹, Stephanie Masina¹, Allan B Becker², Piushkumar Mandhane⁵, Stuart E Turvey⁵, Theo Moraes⁶, Malcolm R Sears⁷, Padmaja Subbarao⁸, Meghan B Azad^{3

2}

Affiliations

¹ School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada.
² Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
³ Manitoba Interdisciplinary Lactation Centre, Winnipeg, MB, Canada.
⁴ School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, People's Republic of China.
⁵ Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
⁶ Department of Paediatrics, BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada.
⁷ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁸ Department of Paediatrics, University of Toronto and Hospital for Sick Children, Toronto, ON, Canada.

Abstract

Objective: To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women.

Design: Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.

Setting: General community setting in four Canadian provinces.

Participants: In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012.

Results: 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.

Conclusions: 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.

Keywords: Breast-feeding continuation; Breast-feeding initiation; Canadian-born; Immigrant; Non-Canadian born.