This article was originally published here
Public Health Nutr. 2021 Dec 3:1-31. doi: 10.1017/S1368980021004699. Online ahead of print.
OBJECTIVE: To identify factors associated with breastfeeding initiation and continuation in Canadian-born and non-Canadian-born women.
DESIGN: Prospective cohort of mothers and infants born from 2008-2012: the CHILD Cohort Study.
SETTING: General community setting in four Canadian provinces.
PARTICIPANTS: 3455 pregnant women from Vancouver, Edmonton, Winnipeg, and Toronto between 2008 and 2012.
RESULTS: Of 3010 participants included in this study, the majority were Canadian-born (75.5%). Breastfeeding initiation rates were high in both non-Canadian-born (95.5%) and Canadian-born participants (92.7%). The median breastfeeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breastfeeding 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 breastfeeding initiation, but not continuation at 6-months postpartum. Factors associated with non-initiation of breastfeeding and cessation at 6-months postpartum were maternal smoking, living with a current smoker, cesarean birth, and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breastfeeding initiation, and lower odds of breastfeeding continuation at 6 months, and older maternal age and recruitment site were associated with breastfeeding continuation at 6 months.
CONCLUSIONS: Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breastfeeding initiation rates, breastfeeding initiation and continuation are more strongly associated with sociodemographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breastfeeding continuation in both groups and may indicate geographic disparities in breastfeeding rates nationally.