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

• Published in: Canadian journal of public health 2015-05, Vol.106 (4), p.e217-e222
• Main Authors: McIsaac, Kathryn E., Moineddin, Rahim, Matheson, Flora I.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Babies; Bias; Breast feeding; Breast Feeding - ethnology; Breastfeeding; Canada - epidemiology; Canadians; Colds; Communicable Disease Control - methods; Communicable Diseases - ethnology; Comparative analysis; Ear diseases; Estimates; Female; Fractions; Gastrointestinal Diseases - ethnology; Gastrointestinal Diseases - prevention & control; Health aspects; Health outcomes; Health Status Disparities; Hospitalization; Humans; Indians, North American - statistics & numerical data; Indigenous peoples; Infant; Infant Mortality - ethnology; Infants; Infections; Inuit; Medicine & Public Health; Middle Aged; Morbidity; Mortality; Native North Americans; Otitis media; Otitis Media - ethnology; Otitis Media - prevention & control; Patient outcomes; Population; Prevention; Public Health; Quantitative Research; Respiratory tract infections; Respiratory Tract Infections - ethnology; Respiratory Tract Infections - prevention & control; Risk; Social classes; Studies; Sudden Infant Death - ethnology; Sudden Infant Death - prevention & control; Sudden infant death syndrome; Young Adult
• ISSN: 0008-4263; 1920-7476
• DOI: 10.17269/cjph.106.4855

OBJECTIVES: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. METHODS: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. RESULTS: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. CONCLUSION:Interventions that promote, protect and support breastfeeding may prevent a substantial proportion of infection and mortality in Canadian Aboriginal infants.