Factors Associated with Breastfeeding Initiation: A Comparison between France and French-Speaking Canada.

PLoS One. 2016 Nov 30;11(11):e0166946. doi: 10.1371/journal.pone.0166946. eCollection 2016.

Girard LC^1,2, Côté SM^3,4,5, de Lauzon-Guillain B^6,7, Dubois L⁸, Falissard B⁹, Forhan A^6,7, Doyle O^2,10, Bernard JY^6,7, Heude B^6,7, Saurel-Cubizolles MJ^7,11, Kaminski M^7,11, Boivin M^4,5,12, Tremblay RE^1,2,5,13; EDEN Mother-Child Cohort Study Group.

Author information

• ¹School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland.
• ²Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.
• ³Department of Social and Preventive Medicine, Université de Montreal, Montreal, Canada.
• ⁴Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation, Russia.
• ⁵Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montreal, Montréal, Canada.
• ⁶INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Villejuif, France.
• ⁷Paris Descartes University, Paris, France.
• ⁸School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
• ⁹Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Paris, France.
• ¹⁰School of Economics, University College Dublin, Dublin, Ireland.
• ¹¹INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris, France.
• ¹²School of Psychology, Université Laval, Quebec, Canada.
• ¹³Departments of Pediatrics and Psychology, Université de Montreal, Montréal, Canada.

Abstract

BACKGROUND:

Breastfeeding is associated with multiple domains of health for both mothers and children. Nevertheless, breastfeeding initiation is low within certain developed countries. Furthermore, comparative studies of initiation rates using harmonised data across multiple regions is scarce.

OBJECTIVE:

The aim of the present study was to investigate and compare individual-level determinants of breastfeeding initiation using two French-speaking cohorts.

METHODS:

Participants included ~ 3,900 mothers enrolled in two cohort studies in Canada and France. Interviews, questionnaires, and medical records were utilised to collect information on maternal, family, and medical factors associated with breastfeeding initiation.

RESULTS:

Rates of breastfeeding initiation were similar across cohorts, slightly above 70%. Women in both Canada and France who had higher levels of maternal education, were born outside of their respective countries and who did not smoke during pregnancy were more likely to initiate breastfeeding with the cohort infant. Notably, cohort effects of maternal education at the university level were found, whereby having 'some university' was not statistically significant for mothers in France. Further, younger mothers in Canada, who delivered by caesarean section and who had previous children, had reduced odds of breastfeeding initiation. These results were not found for mothers in France.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE:

While some similar determinants were observed, programming efforts to increase breastfeeding initiation should be tailored to the characteristics of specific geographical regions which may be heavily impacted by the social, cultural and political climate of the region, in addition to individual and family level factors.