Abstract
Objectives
To describe the rates of breastfeeding initiation and breastfeeding for at least six months and identify risk factors for failing to breastfeed for six months among a community sample of mothers in Calgary, Alberta.
Methods
A cohort of women (n=1737) who participated in a longitudinal study of prenatal support and who could be contacted when their child was three years old (n=1147) were invited to participate in a follow-up telephone questionnaire. Of these 1147 women, 780 (69% participating rate) participated and provided breastfeeding data. Risk factors for early cessation of breastfeeding prior to six months were identified using bivariate and multivariable strategies.
Results
Of the 780 women, 95.6% initiated breastfeeding and 71.6% continued to breastfeed for at least six months. Risk factors identified for early cessation included younger maternal age, obesity prior to pregnancy, lower maternal education, working full-time or intending to within the first year, history of depression, depression or anxiety during pregnancy, poor social support, and smoking during pregnancy (all p<0.05). Multivariable analysis revealed that working full-time or intending to within the first year, lower maternal education, obesity prior to pregnancy and anxiety during pregnancy most increased a woman’s risk of early cessation (all p<0.05).
Conclusion
Nearly all mothers initiated breastfeeding and 70% continued to breastfeed for six months, although subgroups of women remained at an elevated risk of early cessation. Research to better understand breastfeeding decisions among women with the risk factors identified is needed to facilitate the development of more effective breastfeeding promotion strategies.
Key words: Breastfeeding, cessation, risk factors, epidemiology
Résumé
Objectifs
Décrire les taux d’initiation de l’allaitement maternel et d’allaitement pendant au moins six mois et cerner les facteurs de risque d’arrêt précoce de l’allaitement (avant six mois) dans un échantillon communautaire de mères vivant à Calgary (Alberta).
Méthode
Nous avons invité une cohorte de femmes (n=1 737) ayant pris part à une étude longitudinale sur le soutien prénatal et qui ont pu être contactées quand leur enfant a atteint l’âge de trois ans (n=1 147) à répondre à un questionnaire de suivi téléphonique. De ces 1 147 femmes, 780 (69 %) ont participé au suivi et fourni des données sur l’allaitement. Les facteurs de risque d’arrêt précoce de l’allaitement ont été cernés à l’aide d’analyses bivariées et multivariées.
Résultats
De ces 780 femmes, 95,6 % avaient allaité et 71,6 % avaient continué pendant au moins six mois. Les facteurs de risque d’arrêt précoce étaient la jeunesse de la mère, l’obésité antérieure à la grossesse, un faible niveau d’instruction maternel, le fait de travailler à plein temps ou d’avoir l’intention de le faire avant un an, des antécédents de dépression, la dépression ou l’anxiété durant la grossesse, un manque de soutien social et le tabagisme durant la grossesse (p<0,05 dans tous les cas). L’analyse multivariée a montré que le fait de travailler à plein temps ou d’avoir l’intention de le faire avant un an, un faible niveau d’instruction maternel, l’obésité avant la grossesse et l’anxiété durant la grossesse étaient les facteurs qui augmentaient le plus le risque d’arrêt précoce de l’allaitement (p<0,05 dans tous les cas).
Conclusion
Presque toutes les mères avaient allaité et 70 % avaient continué à le faire pendant six mois, mais certains sous-groupes présentaient un risque élevé d’arrêt précoce. Il faudrait pousser la recherche pour mieux comprendre les décisions liées à l’allaitement chez les femmes qui présentent les facteurs de risque cernés, afin de faciliter l’élaboration de stratégies de promotion de l’allaitement plus efficaces.
Mots clés: allaitement maternel, arrêt précoce, facteurs de risque, épidémiologie
Footnotes
Acknowledgements: The Community Perinatal Care Study was funded by the Calgary Children’s Initiative, the Physicians Partnership Steering Committee and the Child and Women’s Health Portfolio of the Calgary Health Region.
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