Factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women: a multi-centre study.

OBJECTIVE: To identify factors associated with breast-feeding initiation and continuation in Canadian-born and non-Canadian-born women. DESIGN: Prospective cohort of mothers and infants born from 2008 to 2012: the Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study. SETTING: General community setting in four Canadian provinces. PARTICIPANTS: In total, 3455 pregnant women from Vancouver, Edmonton, Winnipeg and Toronto between 2008 and 2012. RESULTS: Of 3010 participants included in the current study, the majority were Canadian-born (75·5 %). Breast-feeding initiation rates were high in both non-Canadian-born (95·5 %) and Canadian-born participants (92·7 %). The median breast-feeding duration was 10 months in Canadian-born participants and 11 months in non-Canadian-born participants. Among Canadian-born participants, factors associated with breast-feeding initiation and continuation were older maternal age, higher maternal education, living with their partner and recruitment site. Rooming-in during the hospital stay was also associated with higher rates of breast-feeding initiation, but not continuation at 6-month postpartum. Factors associated with non-initiation of breast-feeding and cessation at 6-month postpartum were maternal smoking, living with a current smoker, caesarean birth and early-term birth. Among non-Canadian-born participants, maternal smoking during pregnancy was associated with lower odds of breast-feeding initiation and lower odds of breast-feeding continuation at 6 months, and older maternal age and recruitment site were associated with breast-feeding continuation at 6 months. CONCLUSIONS: Although Canadian-born and non-Canadian-born women in the CHILD cohort have similar breast-feeding initiation rates, breast-feeding initiation and continuation are more strongly associated with socio-demographic characteristics in Canadian-born participants. Recruitment site was strongly associated with breast-feeding continuation in both groups and may indicate geographic disparities in breast-feeding rates nationally.

High education and increased parity are associated with breast-feeding initiation and duration among Australian women.

OBJECTIVE: Breast-feeding is associated with positive maternal and infant health and development outcomes. To assist identifying women less likely to meet infant nutritional guidelines, we investigated the role of socio-economic position and parity on initiation of and sustaining breast-feeding for at least 6 months. DESIGN: Prospective cohort study. SETTING: Australia. SUBJECTS: Parous women from the Australian Longitudinal Study on Women's Health (born 1973-78), with self-reported reproductive and breast-feeding history (N 4777). RESULTS: While 89 % of women (83 % of infants) had ever breast-fed, only 60 % of infants were breast-fed for at least 6 months. Multiparous women were more likely to breast-feed their first child (~90 % v. ~71 % of primiparous women), and women who breast-fed their first child were more likely to breast-feed subsequent children. Women with a low education (adjusted OR (95 % CI): 2·09 (1·67, 2·62)) or a very low-educated parent (1·47 (1·16, 1·88)) had increased odds of not initiating breast-feeding with their first or subsequent children. While fewer women initiated breast-feeding with their youngest child, this was most pronounced among high-educated women. While ~60 % of women breast-fed their first, second and third child for at least 6 months, low-educated women (first child, adjusted OR (95 % CI): 2·19 (1·79, 2·68)) and women with a very low (1·82 (1·49, 2·22)) or low-educated parent (1·69 (1·33, 2·14)) had increased odds of not breast-feeding for at least 6 months. CONCLUSIONS: A greater understanding of barriers to initiating and sustaining breast-feeding, some of which are socio-economic-specific, may assist in reducing inequalities in infant breast-feeding.

Effect of immediate and continuous mother-infant skin-to-skin contact on breastfeeding self-efficacy of primiparous women: a randomised control trial.

OBJECTIVE: To evaluate the effect of mother-infant immediate skin-to-skin contact on primiparous mother's breastfeeding self-efficacy. STUDY DESIGN: A randomised control trial. SETTINGS: The study was conducted in Omolbanin obstetrics hospital (large tertiary hospital), Mashhad, Iran. PARTICIPANTS: 114 18-35 year-old primiparous, Iranian, healthy and full term mothers who anticipated normal vaginal delivery and intended to breastfeed their babies. INTERVENTION: Skin-to-skin contact immediately after birth and then controlling breastfeeding self-efficacy at 28 days postpartum. MAIN OUTCOME MEASURE: Maternal breastfeeding self-efficacy at 28 days postpartum and success in first breastfeeding and mean time of first breastfeeding initiation. RESULTS: A total of 92 mother-infant dyads (47 dyads in skin-to-skin care skin-to-skin contact group and 45 dyads in routine care group) were monitored and analysed. In skin-to-skin contact group, breastfeeding self-efficacy was 53.42±8.57 SD as compared to 49.85±5.50 SD in routine care group which is significantly higher in skin-to-skin contact group (p=0.0003). Successful breastfeeding initiation rate was 56.6% in skin-to-skin contact group as compared to 35.6% in routine care group (p=0.02). Time to initiate first feed was 21.98±9.10 SD min in SSC group vs. 66.55±20.76 min in routine care group (p<0.001). CONCLUSION: Mother-infant immediate skin-to-skin contact is an easy and available method of enhancing maternal breastfeeding self-efficacy. High breastfeeding self-efficacy increases exclusive breastfeeding duration.