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


CONCLUSIONS
Interventions that promote, protect and support breastfeeding may prevent a substantial proportion of infection and mortality in Canadian Aboriginal infants.
Dalla Lana School of Public Health, University of Toronto; 155 College Street, 6th Floor Toronto Ontario, Canada, M5T3M7 Centre for Research on Inner City Health, St. Michael's Hospital, 209 Victoria Street, 3rd Floor, Toronto, Ontario, Canada M4C2T7. kathryn.mcisaac@alum.utoronto.ca.
Kathryn E
KE
McIsaac
Rahim
R
Moineddin
Flora I
FI
Matheson
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000208:ethnology*; D002170:Canada / Q000453:epidemiology; D003140:Communicable Disease Control / Q000379:methods; D003141:Communicable Diseases / Q000208:ethnology; D005260:Female; D005767:Gastrointestinal Diseases / Q000208:ethnology / Q000517:prevention & control; D054624:Health Status Disparities; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007223:Infant; D007226:Infant Mortality / Q000208:ethnology*; D008875:Middle Aged; D009017:Morbidity; D010033:Otitis Media / Q000208:ethnology / Q000517:prevention & control; D012141:Respiratory Tract Infections / Q000208:ethnology / Q000517:prevention & control; D012306:Risk; D013398:Sudden Infant Death / Q000208:ethnology / Q000517:prevention & control; D055815:Young Adult
Aboriginal; breast feeding; communicable diseases; epidemiology; sudden infant death