Maternal chronic disease and breastfeeding outcomes: a Canadian population-based study

Abstract

Background

The prevalence of chronic disease in pregnant women has consistently risen over the past two decades. Substantial evidence demonstrates that maternal chronic disease is associated with adverse medical outcomes like preterm birth, but less research has characterized postpartum outcomes such as infant feeding practices. It is recommended that infants be exclusively breastfed from birth to 6 months given the numerous health benefits it provides.

Objective

To determine the association between maternal chronic disease and breastfeeding outcomes.

Methods

We analyzed cross-sectional self-report data from the 2015/2016 Canadian Community Health Survey, restricted to women who gave birth within 2 years of data collection (n = 2100, rounded). The exposure was professionally diagnosed chronic physical disease (e.g. diabetes, arthritis, heart disease). The outcomes were breastfeeding non-initiation and early cessation of breastfeeding before 6 months. Multivariable logistic regression modeling was used to estimate adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Estimates were bootstrapped and weighted to represent the national population.

Results

Overall, 11.9% (95% CI 9.8–14.1) of women reported chronic disease, and were more likely to be single, be Canadian born, have low education, and be overweight/obese than women without chronic disease. The mean maternal age was approximately 30 years in both groups. Women with chronic disease had similar odds of breastfeeding non-initiation (AOR 0.96, 95% CI 0.54–1.71) and early cessation of any breastfeeding (AOR 1.40, 95% CI 0.82–2.40), but over twice the odds of early cessation of exclusive breastfeeding (AOR 2.48, 95% CI 1.49–4.12) compared to unaffected women.

Conclusion

Mothers with chronic disease initiate and continue some form of breastfeeding to six months as often as their unaffected peers. However, they have substantially higher odds of ceasing exclusive breastfeeding before the recommended 6 months. Findings suggest a need to investigate the reasons for this disparity to ensure that appropriate breastfeeding support is available for women with chronic disease and their children.

Keywords:

• Breastfeeding
• Canadian Community Health Survey
• chronic disease
• postpartum

Acknowledgments

The analysis was conducted at the Prairie Regional Data Center, which is part of the Canadian Research Data Center Network (CRDCN). The services and activities provided by the CRDCN are made possible by the financial or in-kind support of the SSHRC, the CIHR, the CFI, Statistics Canada, and participating universities whose support is gratefully acknowledged. The views expressed in this paper do not necessarily represent the CRDCN’s or that of its partners. No external funding was sought for this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The Canadian Community Health Survey dataset is available from Statistics Canada: http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226.

Additional information

Funding

NVS is supported by a Canadian Institutes of Health Research Canada Graduate Scholarship Doctoral Award.