Determinants of Breast-Feeding and Weaning in Alberta, Canada

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Abstract

Objective: To assess the determinants of breast-feeding initiation and duration at the population level in Alberta, Canada.

Methods: Determinants of breast-feeding were assessed based on data from a sample of 1 1 13 women, who represented 150 898 fertile women in Alberta, in the second cycle of the National Population Health Survey conducted 1996-97. Logistic regression analysis was used to estimate the independent effects of various determinants of breast-feeding initiation and duration dichotomized at 4 weeks, 8 weeks, 12 weeks, and 6 months postpartum. Ali analyses used analytic weights to take both the average design effect and population weights for the complex survey design into account.

Results: The proportion of breast-feeding initiation was 85.6%. It was observed that 71.3% of mothers continued breast-feeding for at least 3 months, and 37.2% of mothers breast-fed their infants for more than 6 months. Determinants of breast-feeding initiation were marital status, education, maternal smoking behaviour, and annual family income. White women and women who were older than 35 years of age were more likely to continue breast-feeding for longer periods, whereas those who smoked during pregnancy were less likely to breast-feed their infants for extended periods. The primary reasons for weaning were breast problems at less than 1 week, insufficient milk production during weeks 1 to 12, and infants who weaned themselves after 3 months.

Conclusions: Smoking cessation during pregnancy, adequate treatment of early breast problems, and breast-feeding promotion campaigns targeting socioeconomically disadvantaged populations could serve to increase breast-feeding in Canada.

Résumé

Objectif : Évaluer les déterminants de l’amorce et de la durée de l’allaitement maternel au niveau de la population en Alberta, au Canada.

Méthodes : Les déterminants de l’allaitement maternel ont été évalués en fonction des données tirées d’un échantillon de 1 113 femmes, lequel représentait 150 898 femmes fertiles en Alberta, du second cycle de l’Enquête nationale sur la santé de la population menée en 1996-97. Une analyse de régression logistique a été utilisée pour estimer les effets indépendants de divers déterminants de l’amorce et de la durée de l’allaitement maternel dichotomisés à 4 semaines, à 8 semaines, à 12 semaines et à 6 mois post-partum. Toutes les analyses ont fait appel à des coefficients de pondération analytiques en vue de tenir compte des pondérations moyennes (tant de la population que de l’effet de la conception) propres à la complexe conception de l’enquête en question.

Résultats : La proportion de l’amorce de l’allaitement maternel était de 85,6 %. On a constaté que 71,3 % des mères ont poursuivi l’allaitement pendant au moins trois mois et que 37,2 % des mères allaitaient leur enfant pendant plus de six mois. Les déterminants de l’amorce de l’allaitement maternel étaient l’état matrimonial, l’éducation, les habitudes maternelles quant au tabagisme et le revenu familial annuel. Les femmes blanches et les femmes de plus de 35 ans présentaient une tendance accrue à poursuivre l’allaitement pendant des périodes prolongées, alors que les femmes qui avaient fumé au cours de leur grossesse présentaient plutôt une tendance moindre à en faire autant. Les principales raisons motivant le sevrage étaient les problèmes mammaires (à moins d’une semaine), la production de lait insuffisante (entre la 1re et la 12e semaine) et les enfants qui se sevraient eux-mêmes (après 3 mois).

Conclusions : L’abandon du tabac au cours de la grossesse, le traitement adéquat des problèmes mammaires précoces et la mise en œuvre de campagnes de promotion de l’allaitement maternel visant les populations défavorisées sur le plan socioéconomique pourraient entraîner une hausse de l’allaitement maternel au Canada.

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