Abstract
Background
Although previous unpublished research has demonstrated low breastfeeding rates among the James Bay Cree of Northern Ontario, the reasons for this are not immediately clear.
Methods
A retrospective medical chart review of women who had given birth at the Weeneebayko General Hospital in Moose Factory, Ontario in the seven-year period 1997 to 2003 was performed. A variety of demographic variables were documented and overall breastfeeding initiation rates and yearly variations were assessed.
Results
Univariate chi-square analysis of the data indicated that young maternal age (mean=23; p=0.001), maternal smoking (average rate=52.1%; p=0.03), living location (in a small coastal community; p=0.001); and low education status (not completing high school; p<0.001) were risk factors for a mother choosing not to breastfeed. Regression analysis revealed that only living in small coastal communities and not having post-secondary education were independently associated with not breastfeeding. Absence of a partner nearly reached statistical significance on regression analysis (p=0.056). The overall breastfeeding initiation rates (51.9%, 95% CI: 49.3–54.5) were confirmed to be lower than the national average (78%), and the rate has remained low over the seven years of the study.
Conclusion
These results should help clarify why some mothers in the Moose Factory region are at risk of not breastfeeding. This information will be useful in directing future research on the differences in breastfeeding rates among different Aboriginal Peoples’ communities, and assist in the development of program policies specific to women who have one or more of the identified risk factors.
Key words: Indians, North American; risk factors; breast feeding; retrospective study
Résumé
Contexte
Des études encore inédites font état de faibles taux d’allaitement chez les Cris de la baie James du Nord de l’Ontario, mais les raisons de cette situation n’apparaissent pas clairement.
Méthode
Nous avons mené une étude rétrospective des fiches médicales des femmes ayant accouché à l’hôpital général Weeneebayko de Moose Factory (Ontario) sur une période de sept ans (1997 à 2003). Nous avons documenté diverses variables démographiques et analysé les taux d’allaitement maternel globaux et leurs variations annuelles.
Résultats
Une analyse du khi-carré univariée a montré que le jeune âge des mères (moyenne=23 ans; p=0,001), le tabagisme maternel (taux moyen=52,1 %; p=0,03), le lieu de vie (petite localité côtière; p=0,001); et la sous-scolarisation (abandon des études secondaires; p<0,001 ) étaient des facteurs de risque de ne pas allaiter. Une analyse de régression a montré que seules deux variables (vivre dans une petite localité côtière et ne pas avoir fait d’études postsecondaires) étaient liées de façon indépendante au fait de ne pas allaiter. L’absence de partenaire était aussi très proche d’avoir une signification statistique selon l’analyse de régression (p=0,056). Les taux d’allaitement materne globaux (51,9 %, IC de 95 % = 49,3–54,5) étaient effectivement plus faibles que la moyenne nationale (78 %) et le sont demeurés pendant les sept années de l’étude.
Conclusion
Ces résultats devraient contribuer à clarifier pourquoi certaines mères de la région de Moose Factory risquent de ne pas allaiter. Cette information sera utile pour orienter les études futures des différences dans les taux d’allaitement de diverses communautés autochtones; elle devrait aussi faciliter l’élaboration de politiques et de programmes axés sur les femmes qui présentent un ou plusieurs des facteurs de risque indiqués.
Mots clés: Amérindiens, facteurs de risque, allaitement, étude rétrospective
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