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Breastfeeding as a means to prevent infant morbidity and mortality in Aboriginal Canadians: A population prevented fraction analysis.

https://arctichealth.org/en/permalink/ahliterature265523
Source
Can J Public Health. 2015;106(4):e217-22
Publication Type
Article
Date
2015
Author
Kathryn E McIsaac
Rahim Moineddin
Flora I Matheson
Source
Can J Public Health. 2015;106(4):e217-22
Date
2015
Language
English
Geographic Location
Canada
Publication Type
Article
Abstract
Canadian Aboriginal infants experience poor health compared with other Canadian infants. Breastfeeding protects against many infant infections that Canadian Aboriginals disproportionately experience. The objective of our research was to estimate the proportion of select infant infection and mortality outcomes that could be prevented if all Canadian Aboriginal infants were breastfed.
We used Levin's formula to estimate the proportion of three infectious outcomes and one mortality outcome that could be prevented in infancy by breastfeeding. Estimates were calculated for First Nations (both on- and off-reserve), Métis and Inuit as well as all Canadian infants for comparison. We extracted prevalence estimates of breastfeeding practices from national population-based surveys. We extracted relative risk estimates from published meta-analyses.
Between 5.1% and 10.6% of otitis media, 24.3% and 41.4% of gastrointestinal infection, 13.8% and 26.1% of hospitalizations from lower respiratory tract infections, and 12.9% and 24.6% of sudden infant death could be prevented in Aboriginal infants if they received any breastfeeding.
Interventions that promote, protect and support breastfeeding may prevent a substantial proportion of infection and mortality in Canadian Aboriginal infants.
PubMed ID
26285193 View in PubMed
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Exclusive breastfeeding among Canadian Inuit: results from the Nunavut Inuit Child Health Survey.

https://arctichealth.org/en/permalink/ahliterature271871
Source
J Hum Lact. 2014 May;30(2):229-41
Publication Type
Article
Date
May-2014
Author
Kathryn E McIsaac
Wendy Lou
Daniel Sellen
T Kue Young
Source
J Hum Lact. 2014 May;30(2):229-41
Date
May-2014
Language
English
Publication Type
Article
Keywords
Breast Feeding - ethnology - statistics & numerical data
Canada - epidemiology - ethnology
Cross-Sectional Studies
Financial Support
Humans
Inuits - statistics & numerical data
Surveys and Questionnaires
Abstract
Very little population-based research has been conducted around the exclusive breastfeeding practices of Inuit Canadians.
This research aims to assess the distribution of exclusive breastfeeding among Inuit Canadians and to identify factors associated with exclusive breastfeeding as recommended.
We use data from 188 infant-mother dyads who completed the Nunavut Inuit Child Health Survey, a cross-sectional, population-based survey of Inuit children aged 3 to 5 years. A series of multinomial logistic regression models were run to identify factors associated with 4 exclusive breastfeeding durations (= 1 month, > 1- 6.5 months).
Of infants, 23% were exclusively breastfed as recommended (ie, between 5.5 and 6.5 months; 95% CI, 16.2-29.3). Many infants (61%) were exclusively breastfed for less than 5.5 months and 16% (95% CI, 10.9-22.0) were exclusively breastfed for more than 6.5 months. Families receiving income support were less likely to discontinue exclusive breastfeeding before 5.5 months (pOR1-
PubMed ID
24352650 View in PubMed
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Household food security and breast-feeding duration among Canadian Inuit.

https://arctichealth.org/en/permalink/ahliterature274770
Source
Public Health Nutr. 2016 Jul 28;:1-8
Publication Type
Article
Date
Jul-28-2016
Author
Kathryn E McIsaac
David C Stock
Wendy Lou
Source
Public Health Nutr. 2016 Jul 28;:1-8
Date
Jul-28-2016
Language
English
Publication Type
Article
Abstract
There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children.
Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey.
The Canadian Territory of Nunavut in 2007 and 2008.
Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists.
Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14).
Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.
PubMed ID
27465413 View in PubMed
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Household food security and breast-feeding duration among Canadian Inuit.

https://arctichealth.org/en/permalink/ahliterature290128
Source
Public Health Nutr. 2017 Jan; 20(1):64-71
Publication Type
Journal Article
Date
Jan-2017
Author
Kathryn E McIsaac
David C Stock
Wendy Lou
Author Affiliation
1Dalla Lana School of Public Health,University of Toronto,30 Bond Street,Toronto,Ontario,Canada,M5B 1W8.
Source
Public Health Nutr. 2017 Jan; 20(1):64-71
Date
Jan-2017
Language
English
Publication Type
Journal Article
Keywords
Breast Feeding
Canada - epidemiology
Child, Preschool
Cross-Sectional Studies
Family Characteristics
Female
Food Supply
Health Surveys
Humans
Inuits
Lost to Follow-Up
Male
Proportional Hazards Models
Socioeconomic Factors
Time Factors
Abstract
There have been few studies investigating the association between food security and breast-feeding duration and none have been conducted among Canadian Inuit, a population disproportionately burdened with food insecurity. We evaluated the association between household food security and breast-feeding duration in Canadian Inuit children.
Data were obtained from the Nunavut Inuit Child Health Survey, a population-based cross-sectional survey.
The Canadian Territory of Nunavut in 2007 and 2008.
Caregivers of Inuit children aged 3-5 years. Participating children were randomly sampled from community medical centre lists.
Out of 215 children, 147 lived in food-insecure households (68·4 %). Using restricted mean survival time models, we estimated that children in food-secure households were breast-fed for 16·8 (95 % CI 12·5, 21·2) months and children in food-insecure households were breast-fed for 21·4 (95 % CI 17·9, 24·8) months. In models adjusting for social class, traditional knowledge and child health, household food security was not associated with breast-feeding duration (hazard ratio=0·82, 95 % CI 0·58, 1·14).
Our research does not support the hypothesis that children living in food-insecure households were breast-fed for a longer duration than children living in food-secure households. However, we found that more than 50 % of mothers in food-insecure households continued breast-feeding well beyond 1 year. Many mothers in food-secure households also continued to breast-feed beyond 1 year. Given the high prevalence of food insecurity in Inuit communities, we need to ensure infants and their caregivers are being adequately nourished to support growth and breast-feeding, respectively.
PubMed ID
27465413 View in PubMed
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Prevalence and Characteristics Associated with Breastfeeding Initiation Among Canadian Inuit from the 2007-2008 Nunavut Inuit Child Health Survey.

https://arctichealth.org/en/permalink/ahliterature260345
Source
Matern Child Health J. 2015 Feb 6;
Publication Type
Article
Date
Feb-6-2015
Author
Kathryn E McIsaac
Daniel W Sellen
Wendy Lou
Kue Young
Source
Matern Child Health J. 2015 Feb 6;
Date
Feb-6-2015
Language
English
Publication Type
Article
Abstract
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.
PubMed ID
25656726 View in PubMed
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