title: Factors Associated with Breastfeeding Initiation: A Comparison between France and French-Speaking Canada.
abstract: BACKGROUND
  Breastfeeding is associated with multiple domains of health for both mothers and children. Nevertheless, breastfeeding initiation is low within certain developed countries. Furthermore, comparative studies of initiation rates using harmonised data across multiple regions is scarce.
  
  
  OBJECTIVE
  The aim of the present study was to investigate and compare individual-level determinants of breastfeeding initiation using two French-speaking cohorts.
  
  
  METHODS
  Participants included ~ 3,900 mothers enrolled in two cohort studies in Canada and France. Interviews, questionnaires, and medical records were utilised to collect information on maternal, family, and medical factors associated with breastfeeding initiation.
  
  
  RESULTS
  Rates of breastfeeding initiation were similar across cohorts, slightly above 70%. Women in both Canada and France who had higher levels of maternal education, were born outside of their respective countries and who did not smoke during pregnancy were more likely to initiate breastfeeding with the cohort infant. Notably, cohort effects of maternal education at the university level were found, whereby having 'some university' was not statistically significant for mothers in France. Further, younger mothers in Canada, who delivered by caesarean section and who had previous children, had reduced odds of breastfeeding initiation. These results were not found for mothers in France.
  
  
  CONCLUSIONS
  While some similar determinants were observed, programming efforts to increase breastfeeding initiation should be tailored to the characteristics of specific geographical regions which may be heavily impacted by the social, cultural and political climate of the region, in addition to individual and family level factors.
authors.affiliation: School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland.|Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.
authors.forename: Lisa-Christine
authors.initials: LC
authors.lastname: Girard
authors.affiliation: Department of Social and Preventive Medicine, Université de Montreal, Montreal, Canada.|Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation, Russia.|Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montreal, Montréal, Canada.
authors.forename: Sylvana M
authors.initials: SM
authors.lastname: Côté
authors.affiliation: INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Villejuif, France.|Paris Descartes University, Paris, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: de Lauzon-Guillain
authors.affiliation: School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Dubois
authors.affiliation: Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, INSERM, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Falissard
authors.affiliation: INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Villejuif, France.|Paris Descartes University, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Forhan
authors.affiliation: Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.|School of Economics, University College Dublin, Dublin, Ireland.
authors.forename: Orla
authors.initials: O
authors.lastname: Doyle
authors.affiliation: INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Villejuif, France.|Paris Descartes University, Paris, France.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Bernard
authors.affiliation: INSERM, UMR 1153, Epidemiology and Biostatistics Sorbonne Paris Cité Centre (CRESS), Early ORigin of the Child's Health and Development Team (ORCHAD), Villejuif, France.|Paris Descartes University, Paris, France.
authors.forename: Barbara
authors.initials: B
authors.lastname: Heude
authors.affiliation: Paris Descartes University, Paris, France.|INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris, France.
authors.forename: Marie-Josephe
authors.initials: MJ
authors.lastname: Saurel-Cubizolles
authors.affiliation: Paris Descartes University, Paris, France.|INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.affiliation: Institute of Genetic, Neurobiological, and Social Foundations of Child Development, Tomsk State University, Tomsk, Russian Federation, Russia.|Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montreal, Montréal, Canada.|School of Psychology, Université Laval, Quebec, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Boivin
authors.affiliation: School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland.|Geary Institute for Public Policy, University College Dublin, Dublin, Ireland.|Research Unit on Children's Psychosocial Maladjustment (GRIP), Université de Montreal, Montréal, Canada.|Departments of Pediatrics and Psychology, Université de Montreal, Montréal, Canada.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Tremblay
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D005602:France; D006801:Humans; D007802:Language; D009035:Mothers / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011792:Quebec; D055815:Young Adult