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.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Breast Feeding / statistics & numerical data*
  • Cohort Studies
  • Female
  • France
  • Humans
  • Language*
  • Mothers / statistics & numerical data
  • Multivariate Analysis
  • Quebec
  • Young Adult

Grant support

Dr. Girard is supported by a Marie Curie International Incoming Fellowship; the research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme FP7/2007-2013/ under REA grant agreement n° [625014]. We would also like to acknowledge all funding sources for the EDEN study: Foundation for medical research (FRM), National Agency for Research (ANR), National Institute for Research in Public health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris–Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union (FP7, MeDALL project), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environment Security (AFSSET), Mutuelle Générale de l’Education Nationale a complementary health insurance (MGEN), French national agency for food security, French speaking association for the study of diabetes and metabolism (ALFEDIAM). We also acknowledge the Quebec Ministry of Health and Social Services for their funding of the Quebec Longitudinal Study of Child Development (1998–2002) (QLSCD), conducted by Santé Quebec, a division of the Institut de la Statistique du Quebec. None of the funders had any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.