Abstract
Often, efforts to improve overall population health require identifying and targeting programs to specific high-risk populations. Breastfeeding is an example. In order to determine initiation and duration rates among various groups in the City of Toronto, a random sample of 434 mothers with infants at four months of age was surveyed to determine the prevalence of breastfeeding and major impacts on its duration. The study found that, overall, 83% of mothers initiated breastfeeding at birth. The greatest rate of decline occurred during the first month. At four months postpartum, 57% of mothers continued to breastfeed, including 35% who were exclusively breastfeeding and 22% who were supplementing breast milk with formula. Breastfeeding duration was related to a number of factors, including information and support, parity, education, use of formula supplements and country of birth. Specific groups are identified for targeted programs, and a number of strategies are proposed.
Abrégé
Il arrive souvent que les efforts destinés à améliorer la santé de la population exigent l’identification et le ciblage de programmes à l’intention de segments de la population à risque élevé. L’allaitement est un exemple du genre. Afin de déterminer les taux d’amorçage et de durée de l’allaitement au sein de divers groupes dans la ville de Toronto, une enquête a été menée auprès d’un échantillon aléatoire de 434 mères de nourrissons âgés de quatre mois pour déterminer la prévalence de l’allaitement au sein et les principaux facteurs influençant sa durée. L’étude a révélé que, dans l’ensemble, 83 % des mères avaient commencé à allaiter dès la naissance de leurs enfants. Le taux le plus élevé de baisse de l’allaitement se manifeste au cours du premier mois. Quatre mois après leur accouchement, 57 % des mères continuaient d’allaiter, 35 % d’entre elles s’en tenant exclusivement à l’allaitement et 22 % le complétant avec du lait maternisé. La durée de l’allaitement est apparue liée à plusieurs facteurs dont l’information et le soutien disponibles, la parité, le niveau d’études, l’utilisation de suppléments de lait maternisé et le pays d’origine. Plusieurs stratégies sont proposées et certains groupes devant être ciblés par les programmes sont identifiés.
References
- 1.Cunningham AS, Jelliffe OB, Jelliffe EFP. Breastfeeding and health in the 1980s: A global epidemiological review. J Paediatr. 1991;118(5):659–66. doi: 10.1016/S0022-3476(05)80023-X. [DOI] [PubMed] [Google Scholar]
- 2.WHO/UNICEF. Protecting, Promoting and Supporting Breastfeeding: The Special Role of Maternity Services. 1989. [Google Scholar]
- 3.American Dietetic Association. Position of the American Dietetic Association: Promotion and support of breastfeeding. J Am Diet Assoc. 1993;93(4):467–69. doi: 10.1016/0002-8223(93)92300-M. [DOI] [PubMed] [Google Scholar]
- 4.Ontario Public Health Association. Breastfeeding Position Paper. 1993. [Google Scholar]
- 5.Canadian Dietetic Association. Promoting breastfeeding: A role for the dietitian/nutritionist. J Can Diet Assoc. 1989;50(4):211–14. [PubMed] [Google Scholar]
- 6.Nutrition Committee Canadian Paediatric Society. Meeting the iron needs of infants and young children: An update. Can Med Assoc J. 1991;144(11):1451–53. [PMC free article] [PubMed] [Google Scholar]
- 7.Sullivan P. CMA supports breastfeeding, “condemns” contracts between formula makers, hospitals. Can Med Assoc J. 1991;146(9):1610–13. [Google Scholar]
- 8.HealthWelfare Canada. Present Patterns and Trends in Infant Feeding in Canada. Ottawa: Minister of Supply and Services Canada; 1990. [Google Scholar]
- 9.Agnew T, Gilmore J. Breastfeeding Support. Ottawa: Health and Welfare Canada, Minister of Supply and Services; 1993. [Google Scholar]
- 10.Valaitis RK, Ciliska DK, Sheeshka JD, Sword WA. A Survey of Infant Feeding Practices in the Regional Municipality of Hamilton-Wentworth Department of Public Health. 1994. [Google Scholar]
- 11.Deer Regional Health Unit R. Infant Feeding Practices Survey Report. 1992. [Google Scholar]
- 12.City of North York Public Health Department. Survey of Infant Feeding Practices in North York. 1994. [Google Scholar]
- 13.Beaudry M, Aucoin-Larade L. Who breastfeeds in New Brunswick, when and why? Can J Public Health. 1989;80:166–72. [PubMed] [Google Scholar]
- 14.Hill P. Predictors of breastfeeding duration among WIC and non-WIC mothers. Public Health Nurs. 1991;8(1):46–52. doi: 10.1111/j.1525-1446.1991.tb00742.x. [DOI] [PubMed] [Google Scholar]
- 15.Bergevin Y, Dougherty C, Kramer MS. Do infant formula samples shorten the duration of breastfeeding? Lancet. 1983;1:1139–51. doi: 10.1016/s0140-6736(83)92878-7. [DOI] [PubMed] [Google Scholar]
- 16.Maclean H. Implications of a health promotion framework for research on breastfeeding. Health Prom. 1988;34:1–6. [Google Scholar]
- 17.Fishman F, Evans R, Jenks E. Warm bodies, cool milk: Conflicts in post-partum food choice for Indo-Chinese women in California. Soc Sci Med. 1988;26(1):1125–32. doi: 10.1016/0277-9536(88)90188-8. [DOI] [PubMed] [Google Scholar]
- 18.Abramson R. Cultural sensitivity in the promotion of breastfeeding. NAACOG’s Clinical Issues in Perinatal Women’s Health Nursing. 1992;3(4):717–22. [PubMed] [Google Scholar]
- 19.Jingheng H, Yindi X, Yongkin J, Jie X. Evaluation of a health education programme in China to increase breastfeeding rates. Health Prom Int. 1994;9(2):95–8. doi: 10.1093/heapro/9.2.95. [DOI] [Google Scholar]
- 20.Agnew T, Gilmore J. A Multicultural Perspective of Breastfeeding in Canada. Ottawa: Health Canada; 1996. [Google Scholar]
- 21.Piper S, Parks P. Predicting the duration of lactation: Evidence from a national survey. Birth. 1996;23(1):7–12. doi: 10.1111/j.1523-536X.1996.tb00454.x. [DOI] [PubMed] [Google Scholar]