Abstract
Background
Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal)
women breastfeed at lower rates than non-Aboriginal women, and rates vary across and
within Aboriginal populations.
Aim
To determine rates of breastfeeding initiation and maintenance and compare individually
collected survey data with existing routinely collected state and national breastfeeding
data for Aboriginal women.
Methods
CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched
for peer-reviewed literature published between 1995 and 2021. Quantitative studies
written in English and reporting breastfeeding for Aboriginal women or women having
an Aboriginal infant were included. Screening and quality assessment included co-screening
10% of papers. Two reviewers completed data extraction. A proportional meta-analysis
was undertaken for breastfeeding initiation and narrative data synthesis used to summarise
breastfeeding maintenance.
Findings
The initial search identified 12,091 records, with 31 full text studies retrieved,
and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was
78% (95% CI 0.71, 0.84), however, rates were lower than non-Aboriginal women. Maintenance
ranged between one week and five years. Rates and definitions varied significantly
between studies, with inconsistencies in government collection and reporting of breastfeeding.
Conclusion
Significant variation in definitions and reporting make comparisons difficult. Breastfeeding
rates were below recommended targets. Future pattern and trend analyses require standardised
measures and definitions. Current collection and reporting of breastfeeding data,
particularly routinely collected state-based data, is inadequate to present an accurate
picture of current breastfeeding in Australia for Aboriginal women and infants, and
to effectively inform interventions and policies.
Keywords
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References
- Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.Lancet. 2016; 387: 475-490
- How many child deaths can we prevent this year?.Lancet. 2003; 362: 65-71
- Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis.Acta Paediatr. 2015; 104: 30-37
- Effect of breastfeeding on malocclusions: a systematic review and meta-analysis.Acta Paediatr. 2015; 104: 54-61
- Breastfeeding and childhood leukemia incidence.JAMA Pediatr. 2015; 169e151025
- The impact of human milk on necrotizing enterocolitis: a systematic review and meta-analysis.Nutrients. 2020; 12: 1322
- Breastfeeding and reduced risk of sudden infant death syndrome: a meta-analysis.Pediatrics. 2011; 128: 103-110
- Breastfeeding and childhood acute otitis media: a systematic review and meta-analysis.Acta Paediatr. 2015; 104: 85-95
- World Health Organization.Short-term Effects of Breastfeeding: A Systematic Review on the Benefits of Breastfeeding on Diarrhoea and Pneumonia Mortality. World Health Organization, Geneva2013
- Why invest, and what it will take to improve breastfeeding practices?.Lancet. 2016; 387: 491-504
- Breastfeeding and maternal health outcomes: a systematic review and meta-analysis.Acta Paediatr. 2015; 104: 96-113
- The cost of not breastfeeding: global results from a new tool.Health Policy Plan. 2019; 34 (407-17)
United Nations Children's Fund. Innocenti Declaration 2005: United Nations Children's Fund, 2005.
World Health Organization. Guideline: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services, 2017.
World Health Organization and United Nation Children's Fund. Global Breastfeeding Scorecard 2019, 2019.
- Indigenous and tribal peoples' health (The Lancet–Lowitja Institute Global Collaboration): a population study.Lancet. 2016; 388: 131-157
- Indigenous health part 1: determinants and disease patterns.Lancet. 2009; 374: 65-75
- The impact of racial discrimination on the health of Australian Indigenous children aged 5–10 years: analysis of national longitudinal data.Int. J. Equity Health. 2017; 16: 1
- Racism as a determinant of social and emotional wellbeing for Aboriginal Australian youth.Med. J. Aust. 2011; 194: 546-550
Commonwealth of Australia. Bringing them home: National Inquiry into the Separation of Aboriginal and Torres Strait Islander Children from their Families: Commonwealth of Australia, 1997.
- Disappearing, displaced, and undervalued: a call to action for Indigenous health worldwide.Lancet. 2006; 367: 2019-2028
- Indigenous health part 2: the underlying causes of the health gap.Lancet. 2009; 374: 76-85
- Oxford University Press Content P. The Oxford English Dictionary.Clarendon Press, 1989
- Historical, cultural, political, and social influences on dietary patterns and nutrition in Australian Aboriginal children.Am. J. Clin. Nutr. 2000; 72: 1361s-1367ss
- Marketing of Breast-milk Substitutes: National Implementation of the International Code, Status Report 2018.World Health Organization, Geneva2018
Commonwealth of Australia. Review of current interventions and identification of best practice currently used by community based Aboriginal and Torres Strait Islander health service providers in promoting and supporting breastfeeding and appropriate infant nutrition, 1998.
Ministry of Health. Wai 2575 Maori Health Trends Report. Wellington: Ministry of Health, 2019.
Office of Disease Prevention and Health Promotion. Maternal, Infant, and Child Health: MICH-21.5 Increase the proprotion of infants who are breastfed exclusively through 6 months. 2020. 〈https://www.healthypeople.gov/2020/data-search/Search-the-Data#objid=4863〉;.
The National Health Information and Performance Principle Committee. The Australian Health Performance Framework. In: Committee TNHIaPP, editor.: The Australian Government; 2017.
- Australian National Breastfeeding Strategy: 2019 and beyond.ACT: Department of Health, Canberra2019
- Routinely collected infant feeding data: Time for global action.Maternal Child Nutrition. 2018; 14e12616
Commonwealth of Australia. Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report: Australian Health Ministers' Advisory Council, 2017.
- The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.BMJ. 2021; : n71
- Exclusive breastfeeding: measurement and indicators.Int. Breastfeed J. 2014; 9: 18
- Counting breastfeeding: What do we mean and how do we measure it?.Austr. Epidemiol. 2003; 10: 3
- Guideline: counselling of women to improve breastfeeding practices.World Health Organization, 2018
World Health Organization. Indicators for assessing infant and young child feeding practices. Part 1: definitions. 2008.
- Breastfeeding education and support for women with twins or higher order multiples.Cochrane Database Syst. Rev. 2017;
- Systematic reviews in educational research: methodology.Perspectives and Application. Springer Fachmedien Wiesbaden, 2020: 3-22
- Chapter 24: Including non-randomized studies on intervention effects.in: Higgins J.P.T. Thomas J. Chandler J. Cumpston M. Li T. Page M.J. Welch V.A. Cochrane Handbook for Systematic Reviews of Interventions. Cochrane, 2022 (version 6.3 (updated February 2022). Available from www.training.cochrane.org/handbook.)
- Wise practices for cultural safety in electronic health research and clinical trials with Indigenous people: secondary analysis of a randomized clinical trial.J. Med. Internet Res. 2019; 21 (14203-e14203)
- Can cochrane reviews inform decisions to improve Indigenous people’s health?.Cochrane Database Syst. Rev. 2015;
The EndNote Team. EndNote. In: Philadelphia P., editor. EndNote X9 ed: Clarivate; 2013.
- Covidence systematic review software.Veritas Health Innovation, Melbourne, Australia2021
- Assessing the quality of health research from an Indigenous perspective: the Aboriginal and Torres Strait Islander quality appraisal tool.BMC Med. Res. Methodol. 2020; 20: 1
- Stata Statistical Software: Release 17. StataCorp LLC, College Station, TX2021
- Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort.J. Dev. Origins Health Dis. 2016; 7: 481-497
- Initiation and duration of breastfeeding in an Aboriginal community in South Western Sydney.J. Hum. Lact. 2011; 27: 250-261
- Evaluation of an Australian Aboriginal model of maternity care: the malabar community midwifery link service.Women Birth. 2019; 32: 427-436
- Factors influencing breastfeeding rates in south-western Sydney.J. Paediatr. Child Health. 2007; 43: 249-255
- Newborn feeding practices at the time of discharge from hospital in NSW in 2007: a descriptive study.New South Wales Public Health Bulletin. 2009; 20: 177
- Birthweights and growth of infants in five Aboriginal communities.Aust. N. Z. J. Public Health. 2000; 24: 124-135
- 2006-07 north metropolitan Perth breastfeeding cohort study: How long are mothers breastfeeding?.Breastfeed Rev. 2010; 18: 14-24
- Modern and traditional diets for Noongar infants.J. Paediatr. Child Health. 2010; 46: 398-403
- Breastfeeding by Aboriginal mothers in Perth.Nutr. Diet. 2006; 63: 8-14
- Breastfeeding duration and residential isolation amid Aboriginal children in Western Australia.Nutrients. 2012; 4: 2020-2034
- Low rates of predominant breastfeeding in hospital after gestational diabetes, particularly among Indigenous women in Australia.Aust. N.Z. J. Public Health. 2017; 41: 144-150
- Breast-feeding and weaning practices of an urban community of Indigenous Australians.Asia Pac. J. Clin. Nutr. 2000; 9: 232-234
- The maternal and neonatal outcomes for an urban Indigenous population compared with their non-Indigenous counterparts and a trend analysis over four triennia.BMC Pregnancy Childbirth. 2013; 13: 167
- Effect of a Birthing on Country service redesign on maternal and neonatal health outcomes for First Nations Australians: a prospective, non-randomised, interventional trial.Lancet Global Health. 2021; 9: e651-e659
- Improving the engagement of Aboriginal families with maternal and child health services: a new model of care.Public Health Res. Pract. 2020;
- Breastfeeding initiation for Aboriginal and Torres Strait Islander women in Victoria: analysis of routinely collected population-based data.Women Birth. 2017; 30: 361-366
- Initiation rate and duration of breast-feeding in the Melbourne Aboriginal community.Aust. N.Z. J. Public Health. 1997; 21: 500-503
- Dietary intake of Aboriginal Australian children aged 6-36 months in a remote community: a cross-sectional study.Nutr. J. 2020; 19: 1-12
- Associations of gestational diabetes and type 2 diabetes during pregnancy with breastfeeding at hospital discharge and up to 6 months: the PANDORA study.Diabetologia. 2020; 63: 2571-2581
- Initiation and duration of breastfeeding of Aboriginal infants in South Australia.Women Birth. 2019; 32: e315-e322
- Intergenerational and early life influences on the well-being of Australian Aboriginal and Torres Strait Islander children: overview and selected findings from Footprints in Time, the Longitudinal Study of Indigenous Children.J. Dev. Orig. Health Dis. 2019; 10: 17-23
- Poor nutrition from first foods: a cross-sectional study of complementary feeding of infants and young children in six remote Aboriginal communities across northern Australia.Nutr. Diet. 2017; 74: 436-445
- Chapter 7: Systematic reviews of etiology and risk.in: Aromataris E. Munn Z. JBI Manual for Evidence Synthesis. 2020https://doi.org/10.46658/JBIMES-20-08 (JBI, 2020. Available from)
- Aboriginal and Torres Strait Islander Health Performance Framework 2017 Report.Australian Government, Canberra2017
Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework 2020 summary report. Canberra: Australian Institute of Health and Welfare, 2020.
Australian Government. Aboriginal and Torres Strait Islander Health Performance Framework. Measures: Tier 2 - Determinants of Health. 2.20 Breastfeeding practices, 2020.
Health Canada. Breastfeeding Initiation in Canada: Key Statistics and Graphics (2009–2010), 2012.
Ministry of Health. Report on Maternity web tool. 2020. 〈https://www.health.govt.nz/publication/report-maternity-web-tool〉 (accessed 23/9/20).
Centers for Disease Control and Prevention. National Immunization Survey: Breastfeeding Rates, 2017.
- Australia Co Ethical conduct in research with Aboriginal and Torres Strait Islander Peoples and communities: Guidelines for researchers and stakeholders. National Health and Medical Research Council, Canberra2018
- Health Q. Identification of Indigenous Status for Measurement of Perinatal Risk Factors and Outcomes: Insights Gained through Use of Both Mother and Baby Status. Queensland Health, Brisbane, Queensland2015
- Welfare AIoHa An Overview of Aboriginal and Torres Strait Islander Health: Present Status and Future Trends. Australian Government, Canberra1995
- National Best Practice Guidelines for Collecting Indigenous Status in Health Data Sets.Australian Institute of Health and Welfare, Canberra2010
- Comparing life expectancy of Indigenous people in Australia.New Zealand, Canada and the United States: Conceptual, Methodological and Data Issues. Australian Government, Canberra2011
- Dietary intake of Indigenous Australian infants and young children in the Gomeroi Gaaynggal cohort.Nutr. Diet. 2021;
- The association of infant feeding with parent-reported infections and hospitalisations in the West Australian Aboriginal Child Health Survey.Aust. N.Z. J. Public Health. 2008; 32: 207-215
- Infant care practices in a metropolitan Aboriginal population Bibbulung Gnarneep Team.J. Paediatr. Child Health. 1999; 35: 541-544
- Factors associated with the initiation of breast-feeding by Aboriginal mothers in Perth.Public Health Nutr. 2004; 7: 857-861
- Aboriginal mothers, breastfeeding and smoking.Aust. N.Z. J. Public Health. 2004; 28: 225-228
Article Info
Publication History
Published online: March 11, 2022
Accepted:
February 24,
2022
Received in revised form:
January 31,
2022
Received:
October 20,
2021
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
