Rates of and factors associated with exclusive and any breastfeeding at six months in Canada: an analysis of population-based cross-sectional data

Abstract

Background Breastfeeding has many health, economic and environmental benefits for both the infant and pregnant individual. Due to these benefits, the World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of life. The purpose of this study is to examine the prevalence of exclusive and any breastfeeding in Canada for at least six months, and factors associated with breastfeeding cessation prior to six months. Methods We performed a secondary analysis of breastfeeding-related questions asked on the cross-sectional 2017–2018 Canadian Community Health Survey. Our sample comprised 5,392 females aged 15–55 who had given birth in the five years preceding the survey. Descriptive statistics were carried out to assess the proportion of females exclusively breastfeeding and doing any breastfeeding for at least six months by demographic and behavioural factors. We also assessed, by baby’s age, trends in the introduction of solids and liquids, breastfeeding cessation and the reasons females stopped breastfeeding. Multivariate log binominal regression was used to examine the association between breastfeeding at six months and selected maternal characteristics hypothesized a priori to be associated with breastfeeding behaviour. Results Overall, for at least six months, 35.6% (95% confidence interval (CI): 33.3%-37.8%) of females breastfed exclusively and 62.2% (95% CI: 60.0%-64.4%) did any breastfeeding. The largest decline in exclusive breastfeeding occurred in the first month. Factors most strongly associated with breastfeeding for at least six months were having a bachelor’s or higher degree, having a normal body mass index, being married and daily co-sleeping. Insufficient milk supply was given as the most common reason for breastfeeding cessation irrespective of when females stopped breastfeeding. Conclusion Six-month exclusive breastfeeding rates in Canada remain below targets set by the World Health Assembly. Continued efforts, including investment in monitoring of breastfeeding rates, are needed to promote and support exclusive breastfeeding, especially among females vulnerable to early cessation.

Household food insecurity is negatively associated with achievement of prenatal intentions to feed only breast milk in the first six months postpartum

“…Since breastfeeding intentions are modifiable and are associated with later breastfeeding practices, it would be beneficial for national and cohort studies in Canada to collect intentions as part of their infant feeding data ( 33 , 34 ). This would allow for the investigation of associations between relevant social determinants of health and breast milk feeding intentions to further understand the relationship between prenatal intentions and the social disparities in Canadian breastfeeding practices ( 10 , 11 ).…”

“…The most recent national Canadian data indicate that while 91% of infants initiated breastfeeding, only 35% exclusively breastfed to six months ( 10 ). As in other high-income countries, there are social disparities in breastfeeding as this behavior is negatively impacted by the social and structural determinants of health, including HFI ( 11 – 13 ). For instance, secondary data analysis from multiple cycles of the nationally representative, cross-sectional Canadian Community Health Survey found no difference in breastfeeding initiation based on HFI status, but respondents with HFI had lower odds of breastfeeding exclusively to four months ( 14 ).…”

Status of breast cancer detection in young women and potential of liquid biopsy

“…The risk of ER+ cancers also appears to be decreased in women who breastfed ( 80 , 81 ). Additionally, the effectiveness of lactation may be reduced by the decline of breastfeeding duration and breastfeeding overall, with only 35.6% of females exclusively breastfeeding for at least 6 months in Canada as per WHO and Health Canada recommendations ( 82 ). Although a temporary increase in breast cancer risk follows childbirth ( 13 , 65 ), it is succeeded by a long-term protective effect and reduced risk.…”

Prevalencia, beneficios y principales causas de abandono de la lactancia materna

“…Francis et al (2021) reportaron que más de la mitad de las mujeres encuestadas habitaban en hogares con bajos ingresos e inseguridad alimentaria; todas los participantes iniciaron la LM pero solo el 16% alimentó a sus bebés con LME hasta los 6 meses de edad; la inseguridad alimentaria se asoció significativamente con menores tasas de LM. Otro estudio señaló que los factores que más se asociaron con la lactancia hasta los 6 meses fueron alcanzar un nivel de estudio terciario o universitario, tener un IMC normal y estar casada o convivir con la pareja; y la razón más común entre las mujeres por la cual abandonaron la LM fue producción insuficiente de leche (Ricci et al, 2023).…”