Fewer than 2/3 of Canadian newborns exclusively breastfed

Rates of breastfeeding remain suboptimal.

Women who smoke, use drugs, and give birth to twins are less likely to breastfeed exclusively.

Exclusive breastfeeding is not the norm for most term newborns who leave Canadian hospitals, according to a large population-based study in Ontario.

The study, appearing in the Obstetrics and Gynecology, involved over 92,000 babies, 61.6% of whom were eating nothing but breast milk upon hospital discharge.

Looking at predictors of exclusive breastfeeding, the researchers found that nonsmokers were about 63% more likely to do so than smokers, as were non-drug addicts (41%) versus addicts. Prevalence of exclusive breastfeeding was 28% in women not requiring reproductive assistance, 26% in older women, 21% in those who experienced no complications during pregnancy, and only 8% in women of higher socioeconomic status. Newborns with higher Apgar scores and who did not require resuscitation were also more likely to exclusively breastfeed, as were women who gave birth in level II versus level II+ or III facilities.

Women who had a previous term or preterm birth were slightly less likely (4% to 17%) to exclusively breastfeed. Similarly, mothers of twins were 70% less likely to breastfeed, those who had planned or unplanned cesarean deliveries were about 50% less likely than women giving birth vaginally to exclusively breastfeed, and women who did not attend prenatal classes were 20% less likely to do so.

Women cared for by midwives and by family practitioners were about 4.5 times and 67% more likely, respectively, to exclusively breastfeed than women attended by obstetricians. That, however, may be a matter of self-selection that reflects the type of women who seek midwifery or general care. The earlier a baby arrived (ie, 39, 38, and 37 weeks’ gestation), the less likely he/she was to exclusively breastfeed, compared with babies born at 41 weeks’ gestation.

The researchers concluded that rates of exclusive breastfeeding are “suboptimal,” and that identifying predictors of breastfeeding exclusivity is the first step toward developing strategies for new mothers, newborns, healthcare providers, and hospitals to maximize breastfeeding.

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