Prevalence and Factors Affecting Breastfeeding Among Aboriginal Women in Northwestern Ontario

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Abstract

Objective:

To evaluate breastfeeding outcomes among Aboriginal women and to determine variables affecting breastfeeding in the early postpartum period.

Design:

Prospective cohort study.

Setting:

Two sites in Northwestern Ontario, Canada: a tertiary care center and a rural hospital.

Participants:

One hundred thirty breastfeeding Aboriginal women agreed to participate in the study.

Methods:

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 8 weeks postpartum to complete additional questionnaires regarding infant feeding.

Results:

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 8 weeks (78%) postpartum are comparable to other studies. Variables associated with any and exclusive breastfeeding at 8 weeks 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 8 weeks 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 8 weeks.

Conclusion:

Many of the variables may be considered modifiable and amenable to intervention. Targeted interventions should be directed toward improving breastfeeding outcomes among Aboriginal women.

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