Objective: To assess the determinants of breast-feeding initiation and duration at the population level in Alberta, Canada.
Methods: Determinants of breast-feeding were assessed based on data from a sample of 1113 women, who represented 150,898 fertile women in Alberta, in the second cycle of the National Population Health Survey conducted 1996-97. Logistic regression analysis was used to estimate the independent effects of various determinants of breast-feeding initiation and duration dichotomized at 4 weeks, 8 weeks, 12 weeks, and 6 months postpartum. All analyses used analytic weights to take both the average design effect and population weights for the complex survey design into account.
Results: The proportion of breast-feeding initiation was 85.6%. It was observed that 71.3% of mothers continued breast-feeding for at least 3 months, and 37.2% of mothers breast-fed their infants for more than 6 months. Determinants of breast-feeding initiation were marital status, education, maternal smoking behaviour, and annual family income. White women and women who were older than 35 years of age were more likely to continue breast-feeding for longer periods, whereas those who smoked during pregnancy were less likely to breast-feed their infants for extended periods. The primary reasons for weaning were breast problems at less than 1 week, insufficient milk production during weeks 1 to 12, and infants who weaned themselves after 3 months.
Conclusions: Smoking cessation during pregnancy, adequate treatment of early breast problems, and breast-feeding promotion campaigns targeting socioeconomically disadvantaged populations could serve to increase breast-feeding in Canada.