Trends in Breastfeeding Practices and Mothers’ Experience in the French Nutrinet-Santé Cohort.

Abstract BackgroundDespite the suggested health benefits of breastfeeding for infants and mothers,France has one of the lowest rates regarding breastfeeding initiation and duration in the world. Fewstudies have been performed concerning the extent of breastfeeding practices in France since themiddle of the 20th century, or regarding the mothers’ practices from initiation to cessation. Thepurpose of our study is to determine trends in breastfeeding over the past decades and to examinemothers’ perceptions about factors known to have an impact on breastfeeding support and cessation.Methods29,953 parous women from the French NutriNet-Santé cohort were included in theprsent study. Using web-questionnaires, they were asked retrospectively if they breastfed or nottheir youngest child, and if so, the duration of the exclusive and total breastfeeding. For those whohad breastfed, we investigated their perceptions about support at initiation and during the entirebreastfeeding period and the reasons for breastfeeding cessation. We also asked those who did notbreastfeed about their perceptions on non-breastfeeding their youngest child and the reasons forchoosing to bottle-fed him or her. Analyses were weighted according to the French census data.Results67.3% of mothers in the NutriNet-Santé cohort breastfed their youngest child. Theproportion of breastfed children increased tover the past few decades, from 55.0% (95%CI: 54.3 –55.6) in the 1970s to 82.9% (82.4 – 83.4) in the 2010s. Mean total breastfeeding duration was 4.7months (4.5 – 5.0) while exclusive breastfeeding duration was 2.8 months (2.7 – 2.9). Mothers feltsupported at initiation and over the breastfeeding period. 59.5% of mothers reported a desire to havebreastfed more than 2 months longer. Mothers who did not breastfeed did it by choice (64.3%).They did not feel guilty (78.2%) and did not perceive a problem not to breastfeed (58.8%), butalmost half of them would have liked to breastfeed (45.9%).ConclusionBreastfeeding duration has increased in the past decades but did not reach the publichealth recommendations threshold. Other targets than mothers have to be considered, like the fatherand her environment, to increase breastfeeding practices.Trial RegistrationThe study was registered at ClinicalTrials.gov (NCT03335644).