RT Journal Article
SR Electronic
T1 Rates and determinants of exclusive breastfeeding in first 6 months among women in Nova Scotia: a population-based cohort study
JF CMAJ Open
FD Canadian Medical Association
SP E9
OP E17
DO 10.9778/cmajo.20120011
VO 1
IS 1
A1 Catherine R.L. Brown
A1 Linda Dodds
A1 Rebecca Attenborough
A1 Janet Bryanton
A1 Annette Elliott Rose
A1 Gordon Flowerdew
A1 Donald Langille
A1 Leeanne Lauzon
A1 Sonia Semenic
YR 2013
UL http://www.cmajopen.ca/content/1/1/E9.abstract
AB Background Despite compelling evidence that exclusive breastfeeding for the first 6 months of life provides important health benefits to both mothers and their infants, most mothers do not follow this practice. We conducted a study to identify predictors of early cessation of exclusive breastfeeding (before 6 months after delivery). Methods For this population-based longitudinal cohort study, we linked data from a perinatal database and a public health database for infants born between 2006 and 2009 in 2 regions in the province of Nova Scotia, Canada. The cohort was followed from the mother’s first prenatal visit until her infant was 6 months old. Hazard ratios (HRs) for early cessation of exclusive breastfeeding were determined through Cox proportional hazards regression modelling. Results Overall, 64.1% (2907/4533) of the mothers in the cohort initiated breastfeeding. Only 10.4% (413/3957) exclusively breastfed for the recommended 6 months. The largest drop in exclusive breastfeeding occurred within the first 6 weeks after birth. Among the mothers who initiated breastfeeding, significant predictors of early cessation of exclusive breastfeeding identified by multivariable modelling included less than high school education (HR 1.66, 95% confidence interval [CI] 1.35–2.04), lowest neighbourhood income quintile (HR 1.35, 95% CI 1.13–1.60), single motherhood (HR 1.24, 95% CI 1.10–1.41), prepregnancy obesity (HR 1.43, 95% CI 1.23–1.65), smoking throughout pregnancy (HR 1.39, 95% CI 1.21–1.60), no early breast contact by the infant (< 1 hour after birth) (HR 1.44, 95% CI 1.29–1.62) and no intention to breastfeed (HR 1.78, 95% CI 1.44–2.16). Interpretation We found that most predictors of early cessation of breastfeeding were intertwined with social determinants of health. However, we identified potentially modifiable risk factors. Providing opportunities for early breast contact by the infant and continued efforts in smoking cessation and obesity reduction may contribute to a longer duration of exclusive breastfeeding.