Abstract
Objectives
According to Health Canada and the Canadian Paediatric Society, infants should be exclusively breastfed for the first six months with continued breastfeeding for two years and beyond. This study examined the relationship between a mother’s intention to supplement with infant formula and the risk of discontinuing breastfeeding during the 12 months postpartum.
Methods
Surveys were administered to a cohort of mothers at 6 weeks, 6 months and 12 months postpartum as part of York Region’s Infant Feeding Survey. Those who initiated breastfeeding were included in the analysis (n=345). The relationship between a mother’s prenatal intention to supplement with infant formula and breastfeeding duration was examined using Cox proportional hazards regression controlling for mother’s age, prenatal education, immigration status, parity, household income, mother’s ethnicity and education.
Results
Nearly one third of mothers intended to supplement with infant formula. Of those mothers, 69% actually supplemented their baby with infant formula within 12 months postpartum. Intention to supplement was found to be associated with shorter breastfeeding duration (HR=2.64, 95% CI 1.83-3.81). First-time mothers experienced shorter breastfeeding duration compared to experienced mothers (HR=2.13, 95% CI 1.39-3.27). Mothers who identified as European experienced shorter breastfeeding duration compared to East, Southeast or South Asian mothers (HR=1.79, 95% CI 1.05-3.06).
Conclusions
Continued breastfeeding is not only beneficial for the infant, but it also has important benefits for the mother. The analysis indicates that a mother’s prenatal intent to supplement may be associated with shorter breastfeeding duration. Further research is required to confirm these findings and to address the underlying assumptions and limitations.
Résumé
Objectifs
Selon Santé Canada et la Société canadienne de pédiatrie, les nourrissons devraient être exclusivement allaités pendant les six premiers mois, et l’allaitement maternel devrait se poursuivre pendant deux ans et plus. Nous examinons la relation entre l’intention d’une mère de compléter le lait maternel avec de la préparation pour nourrissons et le risque qu’elle cesse d’allaiter au cours des 12 mois qui suivent l’accouchement.
Méthode
Des sondages ont été administrés à une cohorte de mères à 6 semaines, 6 mois et 12 mois du post-partum dans le cadre du sondage «Infant Feeding Survey» de la Région de York. Les mères ayant commencé à allaiter leur enfant étaient incluses dans l’analyse (n=345). À l’aide du modèle de régression à effet proportionnel de Cox, nous avons étudié la relation entre l’intention prénatale d’une mère de compléter le lait maternel avec de la préparation pour nourrissons et la durée de l’allaitement, après avoir apporté des ajustements pour tenir compte des effets de l’âge de la mère, de l’enseignement prénatal, du statut d’immigration, de la parité, du revenu du ménage, ainsi que de l’ethnicité et du niveau d’instruction de la mère.
Résultats
Près du tiers des mères avaient l’intention de compléter leur lait avec de la préparation pour nourrissons. De ces mères, 69 % offraient en effet de la préparation pour nourrissons à leur bébé en plus du lait maternel dans les 12 mois post-partum. L’intention de compléter le lait maternel était associée à une durée d’allaitement abrégée (indice de risque (IR)=2,64, intervalle de confiance (IC) de 95 %: 1,83-3,81). La durée de l’allaitement était plus courte chez les mères primipares que chez les mères multipares (IR=2,13, IC de 95 %: 1,39-3,27). Cette durée était aussi plus courte chez les mères s’identifiant comme d’ascendance européenne que chez les mères venant de l’Asie de l’Est, du Sud-Est ou du Sud (IR=1,79, IC de 95 %: 1,05-3,06).
Conclusions
L’allaitement continu est bénéfique pour le nourrisson, mais comporte aussi d’importants avantages pour la mère. Notre analyse montre que l’intention prénatale de compléter le lait maternel peut être associée à une durée d’allaitement abrégée. Il faudrait pousser la recherche pour confirmer ces constatations et aborder les hypothèses et les contraintes sous-jacentes.
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Acknowledgements: This study was supported by York Region Public Health. The authors are grateful to Caitlin Johnson for assistance with the analysis and review of the manuscript.
Conflict of Interest: None to declare.
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Kim, E., Hoetmer, S.E., Li, Y. et al. Relationship Between Intention to Supplement With Infant Formula and Breastfeeding Duration. Can J Public Health 104, e388–e393 (2013). https://doi.org/10.17269/cjph.104.3898
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DOI: https://doi.org/10.17269/cjph.104.3898