McIsaac Kathryn E, Sellen Daniel W, Lou Wendy, Young Kue
Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T3M7, Canada,
Matern Child Health J. 2015 Sep;19(9):2003-11. doi: 10.1007/s10995-015-1712-3.
We aimed to determine the prevalence of, and factors associated with, breastfeeding initiation in Canadian Inuit. We used data from the Nunavut Inuit Child Health Survey, a population-based, cross-sectional survey conducted in the Canadian territory of Nunavut. Inuit children aged 3-5 years in 2007 or 2008 were randomly selected for the survey. Select household, maternal, infant and community characteristics were collected from the child's primary caregiver and entered into logistic regression models as potential predictors of breastfeeding initiation. Analyses were repeated in a subgroup of caregiver reports from biological mothers. The reported prevalence of breastfeeding initiation was 67.6% (95% CI 62.4-72.8) overall and 85.1% (95% CI 80.2-90.1) in a subgroup of caregiver reports from biological mothers. Adjusted prevalence odds ratios (pOR) indicate the primary caregiver was an important determinant of breastfeeding (adopted parent vs. biological mother: pOR = 0.03, 95% CI 0.01-0.07; other vs. biological mother: pOR = 0.33, 95% CI 0.14-0.74). Maternal smoking during pregnancy and having access to a community birthing facility were also potentially important, but not statistically significant (p > 0.05). In conclusion, data from the Nunavut Inuit Child Health Survey indicate breastfeeding is initiated for more than two-thirds of children, but rates are below the national average and this may be one of several pathways to poor health outcomes documented in many Inuit communities. Considered in the particular context of birthing facilities utilization and postnatal care arrangements in Inuit communities, these results suggest that increasing breastfeeding initiation will require health interventions that effectively engage all types of primary caregivers.
我们旨在确定加拿大因纽特人开始母乳喂养的比例及其相关因素。我们使用了努纳武特因纽特儿童健康调查的数据，这是一项在加拿大努纳武特地区开展的基于人群的横断面调查。2007年或2008年3至5岁的因纽特儿童被随机选入该调查。从孩子的主要照料者那里收集了家庭、母亲、婴儿及社区的特定特征信息，并将其作为开始母乳喂养的潜在预测因素纳入逻辑回归模型。在亲生母亲的照料者报告子组中重复进行了分析。总体而言，报告的开始母乳喂养比例为67.6%（95%置信区间62.4 - 72.8），在亲生母亲的照料者报告子组中为85.1%（95%置信区间80.2 - 90.1）。调整后的患病率比值比（pOR）表明主要照料者是母乳喂养的重要决定因素（养父母与亲生母亲相比：pOR = 0.03，95%置信区间0.01 - 0.07；其他与亲生母亲相比：pOR = 0.33，95%置信区间0.14 - 0.74）。孕期母亲吸烟以及是否有社区分娩设施也可能很重要，但无统计学意义（p > 0.05）。总之，努纳武特因纽特儿童健康调查的数据表明，超过三分之二的儿童开始母乳喂养，但比例低于全国平均水平，这可能是许多因纽特社区记录的健康状况不佳的多种途径之一。结合因纽特社区分娩设施利用和产后护理安排的具体情况来看，这些结果表明，提高母乳喂养率将需要能有效让各类主要照料者参与进来的健康干预措施。
