Predictors of breastfeeding exclusivity among migrant and Canadian-born women: results from a multi-centre study.

The objective of this study was to examine and compare predictors of breastfeeding exclusivity among migrant and Canadian-born women. As part of a longitudinal study, a sample of 1184 mothers were recruited from 12 hospitals in Canada and completed questionnaires at 1 and 16 weeks post-partum that included diverse questions from the following domains: demographic, social, migration, obstetrical, breastfeeding and maternal mood. After bivariate analysis, multivariate logistic regression analysis was completed to examine and compare predictors of exclusive breastfeeding at 16 weeks post-partum. Among migrant women, factors predictive of breastfeeding exclusivity included non-refugee immigrant or asylum-seeking status, residence in Toronto or Vancouver, maternal age of ≥35 years, feels most comfortable in the country of origin or nowhere and higher Gender-related Development Index of the country of origin. Factors predictive of not exclusively breastfeeding included maternal age of <20 years, not planning to exclusively breastfeed, not making the decision to breastfeed before pregnancy and not exclusively breastfeeding at 1 week post-partum. Among Canadian-born women, factors predictive of a lower likelihood of breastfeeding exclusivity included not living with father of infant, infant neonatal intensive care unit admission, planned duration of exclusive breastfeeding for <6 months, not exclusively breastfeeding at 1 week post-partum and Edinburgh Postnatal Depression Scale score of ≥10. The only similar risk factor predicting a lower likelihood of breastfeeding exclusivity between migrant and Canadian-born women was not exclusively breastfeeding at 1 week post-partum; all other risk factors were dissimilar, suggesting that these groups might benefit from different strategies to optimise breastfeeding outcomes.