Breastfeeding practices among the Old Order Mennonites in Ontario, Canada: a multiple methods study.
BACKGROUND
The Old Order Mennonites (OOM) of rural Ontario have a lifestyle that is very distinct from the rest of Canada. Breastfeeding practices among this community have not been described previously.


OBJECTIVE
This study aimed to estimate the prevalence of exclusive breastfeeding (EBF) at 2, 4, and 6 months; to compare the prevalence of EBF among OOM and Canadian women; to investigate factors associated with EBF at 6 months; and to gain qualitative insight into the breastfeeding practices of OOM women.


METHODS
Data on maternal characteristics, delivery factors, and infant feeding methods at birth and at 2, 4, and 6 months were obtained from medical records at the Elmira Medical Centre for all births to OOM women between January 2006 and December 2011. Semi-structured interviews were carried out with 2 lactation consultants working at the Elmira Medical Centre.


RESULTS
Complete breastfeeding data were available for 195 of 225 OOM women (77.4%). The majority of OOM women initiated breastfeeding (87.9%); 81.4% continued to breastfeed exclusively at 2 months, 74.0% to 4 months, and 36.8% to 6 months. Women who had a homebirth (12.3%) had 2.6-fold higher odds of EBF at 6 months (odds ratio, 2.59; 95% confidence interval, 1.03-6.53) compared with women who delivered in a hospital. Cultural and religious influences and community support were suggested as reasons for the relatively high prevalence of EBF.


CONCLUSIONS
Breastfeeding rates among OOM women are consistently higher in the first 6 months of life compared to the general Canadian population. Homebirth independently predicted increased odds of EBF at 6 months.
1Centre for Child & Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol, UK.
Sarah
S
Norris
Simon M
SM
Collin
Jenny
J
Ingram
D000328:Adult; D001942:Breast Feeding / Q000208:ethnology*; D036861:Delivery, Obstetric; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012944:Social Support; D012959:Socioeconomic Factors
Old Order Mennonite; breastfeeding; exclusive breastfeeding; lactation consultant