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10. Continuities and Change: Breastfeeding in Canada at the Turn of the Twenty-First Century
- Wilfrid Laurier University Press
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185 Chapter 10 Continuities and Change: Breastfeeding in Canada at the Turn of the Twenty-First Century O ver the past 150 years, rates of breastfeeding have declined and increased dramatically. Breastfeeding initiation rates in Canada fell from near universal levels at the beginning of the twentieth century to less than 25 percent at mid-century and returned to just over 80 percent at the turn of the twenty-first century. Changes in breastfeeding practices have been accompanied by changes in the availability and promotion of breast milk alternatives, the transmission of breastfeeding knowledge and skills, and the individual and societal value placed on breastfeeding and breast milk. In Canada, the practice of breastfeeding shifted from a private issue to a public concern at the end of the nineteenth century. Throughout the twentieth century many important influences on existing breastfeeding practices and policies emerged. At the beginning of the twenty-first century, as new social trends and values emerge, discussions of the importance and meaning of breastfeeding have grown and breastfeeding continues to receive interest, attention, and support from individuals, professionals, activists, mothers, and various social movements. Breastfeeding Rates in Canada in 2003 In 2003, the Canadian Community Health Survey (CCHS) became the first national survey since the 1960s to collect data on exclusive breastfeeding rates. The CCHS measured the prevalence and duration of breastfeeding in women aged fifteen to fifty-five who had had a baby in the past five years. According to the survey, 85 percent of women attempted to breastfeed their child. Of the women who initiated breastfeeding, 22 percent had stopped by the end of the first month. Fewer than half the women (47 percent) breastfed for six months or more, and fewer than half of these women (17 percent) breastfed exclusively for six months or more (Millar and Maclean 2005). In 2003, a strong east-west gradient in breastfeeding initiation and duration persisted. Initiation rates ranged from 63 percent in Newfoundland and 186 Chapter 10 Labrador to 76 percent in Quebec to 86 percent in Saskatchewan to 93 percent in British Columbia. Exclusive breastfeeding at six months ranged from 9 percent in Newfoundland and Labrador to 18 percent in Ontario, Manitoba, and Saskatchewan to 28 percent in British Columbia. The 2001 Aboriginal Peoples Survey revealed that breastfeeding rates in the Aboriginal population had also been increasing throughout the 1990s. Breastfeeding initiation was approximately 73 percent in 2001. Although initiation rates varied little between First Nations, Inuit, and Metis mothers, duration rates did. The average duration of breastfeeding for Inuit children was fifteen months, compared with eight months for First Nations and seven months for Metis children (Statistics Canada 2001b). At the beginning of the twenty-first century, the majority of mothers in Canada were initiating breastfeeding at rates that resembled those at the beginning of the twentieth century. Since the 1960s, when breastfeeding rates were at their lowest, initiation and duration rates have been increasing. Between the late 1960s and early 1980s, breastfeeding initiation rates accelerated rapidly; rates plateaued nationally at about 75 percent for just over a decade. Initiation rates began to increase again in the mid-1990s from about 75 percent to about 85 percent in 2003. Duration rates have also increased over the past forty years, although at a much slower pace. The growth of Graph 10.1 National breastfeeding initiation trends, 1965–2003 100 90 80 70 60 50 40 30 20 10 0 Percentage of mothers who intitiated breastfeeding 1965 1973 1979 1982 1994 1996 1998 2003 Year Source: Compiled from data found in Myres 1979; McNally, Hendricks, and Horowitz 1985; Health Canada 1985; Dzakpasu 2003; Millar and Maclean 2005. [54.92.155.93] Project MUSE (2024-03-29 11:02 GMT) 187 Continuities and Change: Breastfeeding in Canada at the Turn of the Twenty-First Century exclusive breastfeeding practices has lagged behind the increase in duration rates. Only one in six mothers breastfed exclusively for six months in 2003. National breastfeeding rates hide a wide range of variation in breastfeeding practices across the country, including across social classes and across provinces. In many parts of Canada, particularly in British Columbia and in several social groups, initiation rates are very high. Consequently, growth in breastfeeding is mainly possible in terms of duration and exclusivity. While the rise and fall of breastfeeding in Canada has followed a pattern similar to that found in other Western countries, at the beginning of the twenty-first century, Canadian rates remain lower than those in...