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Social inequalities in infant feeding during the first year of life. The Longitudinal Study of Child Development in Québec (LSCDQ 1998–2002)

Published online by Cambridge University Press:  02 January 2007

Lise Dubois  and
Manon Girard
Lise Dubois*
Affiliation:
Canadian Institute for Advanced Research and Institute of Population Health, University of Ottawa, 1 Stewart, Ottawa, Ontario, CanadaK1N 6N5
Manon Girard
Affiliation:
Canadian Institute for Advanced Research and Institute of Population Health, University of Ottawa, 1 Stewart, Ottawa, Ontario, CanadaK1N 6N5
*
*Corresponding author: Email ldubois@uottawa.ca
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Abstract

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Objective:

The aim of this paper is to describe the source and the scope of social inequalities in infant feeding practices. It examines the extent to which different recommendations are followed in different social groups and highlights the main factors influencing the total adherence to three recommendations at the population level.

Design, setting and subjects:

The study follows a representative sample (n = 2103) of the children born in 1998 in the province of Québec (Canada). Detailed information on breast-feeding and complementary feeding was collected at 5 and 17 months by face-to-face interviews with the mother. The independent variables were mother's age, mother's education level, poverty level, family type, socio-economic status (SES) and living area. Odds ratios (adjusted for baby's rank in the family, birth weight and premature birth) are presented for breast-feeding, and for formula and cows' milk consumption, at different ages. The adherence to a combined indicator cumulating three recommendations (breast-fed at birth, complementary food at 4 months or later and cows' milk at 9 months or later) is also presented.

Results:

The analysis indicates that adherence to the recommendations is low in Québec. Breast-feeding initiation, duration and its exclusivity improved with mother's age and education level and SES. Adherence to the different recommendations was interrelated, indicating an accumulation of bad nutritional circumstances for children in low-SES families. The odds of being fed in accordance with the three studied recommendations, when living in a family with the highest SES, was 2.3 times higher than when living in a family with the lowest SES. When living with a highly educated mother, the odds ratio was 2.7 times higher than when living with a low-educated mother. For mother's age, the odds ratio reached 3.7 for children from mothers aged ≥35 years, in comparison with children from mothers ≤24 years old. When SES or mother's education level was combined with mother's age, the children in the best situation were >8 more times likely than the least privileged children to be fed in accordance with these recommendations. Living area was not related with infant feeding during the first year of life

Conclusions:

Breast-feeding and nutrition could be related with different health and cognitive outcomes in childhood and later in life. Consequently, social disparities in diet during infancy could play a role in the development of social and health inequalities more broadly observed at the population level. Intervention to improve adherence to breast-feeding and nutrition recommendations in infancy should be prioritised and evaluated for its impact on the reduction on infant diet inequalities over time

Keywords

Breast-feedingComplementary feedingSocial inequalitiesPopulation healthQuebec
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 8 , December 2003 , pp. 773 - 783
Copyright
Copyright © CAB International 2003

References

1Société Canadienne de Pédiatrie, les Diététistes du Canada, Santé Canada. La nutrition du nourrisson né à terme et en santé. Ottawa: Ministre des Travaux Publics et Services Gouvernementaux Canada, 1998.Google Scholar
2Kmietowicz, Z. Breastfeeding programmes ‘should be targeted’. British Medical Journal 2000; 321: 467.Google ScholarPubMed
3Sikorski, J, Boyd, F, Dezateux, C, Wade, A, Rowe, J. Prevalence of breastfeeding at four months in general practices in South London. British Journal of General Practice 2001; 51(467): 445–50.Google ScholarPubMed
4Bulk-Bunschoten, AM, van Bodegom, S, Reerink, JD, Pasker-de Jong, PC, de Groot, CJ. Reluctance to continue breastfeeding in The Netherlands. Acta Paediatrica 2001; 90(9): 1047–53.CrossRefGoogle ScholarPubMed
5Scott, JA, Binns, CW. Factors associated with the initation and duration of breastfeeding: a review of the literature. Breastfeed Review 1999; 7(1): 5–16.Google Scholar
6Yngve, A, Sjöström, M. Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends. Public Health Nutrition 2001; 4(2B): 631–45.CrossRefGoogle ScholarPubMed
7Crost, M, Kaminski, M. L'allaitement maternel à la maternité en France en 1995. Enquête nationale périnatale. Archives Pédiatriques 1998; 5: 1316–26.CrossRefGoogle Scholar
8Williams, PL, Innis, SM, Vogel, AM, Stephen, LJ. Factors influencing infant feeding practices of mothers in Vancouver. Canadian Journal of Public Health 1999; 90(2): 114–9.CrossRefGoogle ScholarPubMed
9Hornell, A, Aarts, C, Kylbert, E, Hofvander, Y, Gebre-Medhin, M. Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden. Acta Paediatrica 1999; 88(2): 203–11.CrossRefGoogle ScholarPubMed
10Riva, E, Banderali, G, Agostonic, C, Silano, M, Radaelli, G, Giovannini, M. Factors associated with initiation and duration of breastfeeding in Italy. Acta Paediatrica 1999; 88(4): 411–5.CrossRefGoogle ScholarPubMed
11Ford, RPK, Mitchell, EA, Scragg, R, Stewart, AW, Taylor, BJ, Allen, EM. Factors adversely associated with breast feeding in New Zealand. Journal of Paediatrics and Child Health 1994; 30: 483–9.CrossRefGoogle ScholarPubMed
12Dubois, L, Bédard, B, Girard, M, Beauchesne, É. ‘Diet’ in Longitudinal Study of Child Development in Québec (ÉLDEQ 1998–2002). Québec: Institut de la Statistique du Québec, 2000; 1(5).Google Scholar
13Willms, DJ, Shields, M. A Measure of Socioeconomic Status for the National Longitudinal Survey of Children. Canada: Atlantic Center for Policy Research in Education, Université du Nouveau-Brunswick et Statistique, 1996.Google Scholar
14Freeman, V, van't Hof, M, Haschke, F. Patterns of milk and food intake in infants from birth to age 36 months: the Euro-growth study. Journal of Pediatric Gastroenterology and Nutrition 2000; 31(Suppl. 1): S76–85.CrossRefGoogle ScholarPubMed
15Hediger, ML, Overpeck, MD, Ruan, WJ, Troendle, JF. Early infant feeding and growth status of US-born infants and children aged 4–71 mo: analyses from the third National Health and Nutrition Examination Survey, 1988–1994. American Journal of Clinical Nutrition 2000; 72: 159–67.CrossRefGoogle ScholarPubMed
16Scott, JA, Aitkin, I, Binns, CW, Aroni, RA. Factors associated with the duration of breastfeeding amongst women in Perth, Australia. Acta Paediatrica 1999; 88(4): 356–8.CrossRefGoogle ScholarPubMed
17Aggett, PJ. Research priorities in complementary feeding: International Paediatric Association (IPA) and European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) workshop. Pediatrics 2000; 106(5): 1271–2.CrossRefGoogle ScholarPubMed
18Wharton, B. Patterns of complementary feeding (weaning) in countries of the European Union: topics for research. Pediatrics 2000; 106(5): 1273–4.CrossRefGoogle ScholarPubMed
19Ford, RPK, Schluter, PJ, Mitchell, EA. The New Zealand Cot Death Study Group Factors associated with the age of introduction of solids into the diet of New Zealand infants. Journal of Paediatrics and Child Health 1995; 31(5): 469–72.CrossRefGoogle Scholar
20Weimer, JP. Examining the well-being of children. Food Review 2001; 24(2): 23–6.Google Scholar
21Ball, TM, Wright, AL. Health care costs of formula-feeding in the first year of life. Pediatrics 1999; 103(4 Pt 2): 870–6.CrossRefGoogle ScholarPubMed