Summary: | Background: Inuit populations are less likely to breastfeed than other Canadians and are disproportionately affected by many conditions which breastfeeding is protective against. No population-based research has explored the determinants of breastfeeding initiation and exclusive breastfeeding to six months, as recommended by Health Canada, in this population. Objective: The aim of this research is to examine the prevalence of breastfeeding initiation and exclusive breastfeeding to six months among Canadian Inuit and to identify factors that are associated with both breastfeeding practices. Methods: Data for this research come primarily from two cross-sectional population-based surveys: the Nunavut Inuit Child Health Survey and the IPY Inuit Health Survey. Possible determinants of breastfeeding practices include household, maternal, infant and community characteristics as well as engagement in traditional lifestyle. Logistic regression procedures (i.e. multiple logistic regression; multinomial logistic regression; hierarchal logistic regression) were used to model the determinants of breastfeeding initiation and exclusive breastfeeding as recommended. Results: The prevalence of breastfeeding initiation was 67% (95% CI: 62.8-72.4) in the entire sample and 76% (95% CI: 70.6-82.1) in children raised by their biological mother. Twenty-three percent of Inuit Canadians practiced exclusive breastfeeding as recommended (95% CI: 16.2-29.3). Among children being raised by their biological mother, infants of low birth weight and whose mothers smoked during pregnancy were less likely to begin breastfeeding (OR: 0.16, 95%CI: 0.10-0.27; OR: 0.34, 95%CI: 0.19-0.61, respectively), while infants in crowded households were more likely to begin breastfeeding (OR=2.01, 95%CI: 1.39-2.94). Families currently receiving income support were less likely to stop exclusive breastfeeding their infant before 5.5 months (OR≤1month=0.39, 95%CI: 0.14-1.05; OR1-<5.5 months=0.34, 95%CI: 0.13-0.85). There was no relationship between classes of traditional lifestyle and either breastfeeding initiation or exclusive breastfeeding as recommended. Conclusions: These data suggest substantial room for improving breastfeeding practices of Inuit Canadians, which may provide downstream health benefits to Inuit children. Increasing exclusive breastfeeding to six months will require targeted interventions. PhD
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