Prevalence and Characteristics Associated with Breastfeeding Initiation Among Canadian Inuit from the 2007–2008 Nunavut Inuit Child Health Survey

Abstract

We aimed to determine the prevalence of, and factors associated with, breastfeeding initiation in Canadian Inuit. We used data from the Nunavut Inuit Child Health Survey, a population-based, cross-sectional survey conducted in the Canadian territory of Nunavut. Inuit children aged 3-5 years in 2007 or 2008 were randomly selected for the survey. Select household, maternal, infant and community characteristics were collected from the child's primary caregiver and entered into logistic regression models as potential predictors of breastfeeding initiation. Analyses were repeated in a subgroup of caregiver reports from biological mothers. The reported prevalence of breastfeeding initiation was 67.6% (95% CI 62.4-72.8) overall and 85.1% (95% CI 80.2-90.1) in a subgroup of caregiver reports from biological mothers. Adjusted prevalence odds ratios (pOR) indicate the primary caregiver was an important determinant of breastfeeding (adopted parent vs. biological mother: pOR = 0.03, 95% CI 0.01-0.07; other vs. biological mother: pOR = 0.33, 95% CI 0.14-0.74). Maternal smoking during pregnancy and having access to a community birthing facility were also potentially important, but not statistically significant (p > 0.05). In conclusion, data from the Nunavut Inuit Child Health Survey indicate breastfeeding is initiated for more than two-thirds of children, but rates are below the national average and this may be one of several pathways to poor health outcomes documented in many Inuit communities. Considered in the particular context of birthing facilities utilization and postnatal care arrangements in Inuit communities, these results suggest that increasing breastfeeding initiation will require health interventions that effectively engage all types of primary caregivers.

Household food security and breast-feeding duration among Canadian Inuit

“…Children living in one of the sixteen selected communities were randomly sampled from lists provided by the community health centres and, as the sole source of health care in these communities, these lists were expected to be free of coverage errors. More information about the sampling strategy and the generation of sampling weights is provided elsewhere ( 4 , 21 ) .…”

“…Because our prior research has demonstrated food insecurity was not associated with beginning breast-feeding ( 21 ) , we restricted the present study to children who received some breast-feeding as infants. We excluded children who did not initiate breast-feeding because we were specifically interested in knowing, among those mothers who already began breast-feeding, whether food security played an instrumental role in their decision to continue breast-feeding.…”

“…Moreover, the findings have been inconsistent: differences in study populations, definitions of food security and control for confounding could be driving these inconsistencies. Previous research has examined how food insecurity impacted breast-feeding initiation ( 21 ) and exclusive breast-feeding at 6 months ( 16 ) among Canadian Inuit infants, but failed to find sufficient evidence to support associations. However, existing research suggests food insecurity may have the greatest impact on breast-feeding duration beyond the infant’s first 6 months of life and there has been no work in this regard in Inuit communities ( 19 , 20 ) .…”