Prevalence and Factors Affecting Breastfeeding Among Aboriginal Women in Northwestern Ontario

ObjectiveTo evaluate breastfeeding outcomes among Aboriginal women and to determine variables affecting breastfeeding in the early postpartum period.DesignProspective cohort study.SettingTwo sites in Northwestern Ontario, Canada: a tertiary care center and a rural hospital.ParticipantsOne hundred thirty breastfeeding Aboriginal women agreed to participate in the study.MethodsAll women completed a baseline survey in hospital that included questions regarding demographic, prenatal, breastfeeding, obstetric, postpartum, and neonatal characteristics. Women were then telephoned at 4 and 8 weeks postpartum to complete additional questionnaires regarding infant feeding.ResultsLow rates of breastfeeding initiation (69%) and exclusive breastfeeding were identified at 4 (37.5%) and 8 (35.3%) weeks postpartum. Among those who initiated breastfeeding, duration rates at 4 (86%) and 8 weeks (78%) postpartum are comparable to other studies. Variables associated with any and exclusive breastfeeding at 8 weeks included the following: (a) household income, (b) intended breastfeeding duration, (c) plan to exclusively breastfeed, (d) perception of meeting their planned duration goal, and (e) higher breastfeeding self‐efficacy. Partner support was associated with any breastfeeding at 8 weeks but not exclusivity. Women who were breastfeeding exclusively in hospital (prevalence ratio PR] = .48, 95% confidence interval CI] 0.27, 0.86]), did not smoke (PR = 2.5, 95% CI 1.4, 4.3]) and/or use substances during pregnancy (PR = 4.5, 95% CI 1.5, 14]) were more likely to be breastfeeding exclusively at 8 weeks.ConclusionMany of the variables may be considered modifiable and amenable to intervention. Targeted interventions should be directed toward improving breastfeeding outcomes among Aboriginal women.