Prevalence, duration and factors associated with breastfeeding in French Guiana in 2024

Exclusive breastfeeding is essential for health throughout life. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months, as well as continued breastfeeding for up to two years or more in addition to an appropriate diet. In French Guiana, a French overseas territory characterized by cultural diversity, socioeconomic inequalities, and structural healthcare challenges, there was a lack of recent, representative data on breastfeeding practices. The ANJE Nutri study aimed to estimate the prevalence of breastfeeding practices and to identify factors associated with exclusive breastfeeding at four months (EBF-4), the national benchmark defined by the French National Nutrition and Health Program (PNNS).

This multicenter survey was conducted by telephone with mothers included in the Nutri Pou Ti'moun study approximatively 12 months after delivering in one of French Guiana's three maternity wards. Multilingual interviewers collected data using a structured questionnaire designed to measure Infant and Young Child Feeding (IYCF) indicators. Modified Poisson regression was used to identify factors associated with EBF-4.

Between March and October 2024, 382 mother-child pairs were included in the study. The majority of infants (91.6%) were ever breastfed, including 89.8% in the maternity stay, with a median breastfeeding duration of six months. Among children born in the last 12 months, 51.6% were ever exclusively breastfed, including 20.1% in the maternity stay, with a median breastfeeding duration of three months. The prevalence of EBF-4 was 22.3% [95% CI: 17.8-27.6]. In the maternity stay, 77.4% of breastfed infants received maternity supplement (MS), mainly infant formula. Professional breastfeeding support was reported by 69.6% of mothers during the maternity stay and by 40.9% after discharge; 22.8% wished they had received support but did not. In the multivariate analysis, EBF-4 was positively associated with younger maternal age (under 20 years) [PR: 4.2; 95% CI: 2.3-7.7] and higher education level [PR: 2.0; 95% CI: 1.2-3.4]. EBF-4 was negatively associated with being born in French Guiana (compared to women born in Haiti) [PR: 0.4; 95% CI: 0.2-0.8] and with the introduction of maternity supplements [PR: 0.3; 95% CI: 0.2-0.5].

Overall breastfeeding rates in French Guiana are encouraging, yet EBF-4 remains low. The early and frequent use of MS and disparities in access to breastfeeding support were associated with lower likelihood of sustaining exclusive breastfeeding and breastfeeding. These findings underscore the necessity of providing early, coordinated, and culturally appropriate support strategies that are tailored to the diverse maternal profiles in this territory, particularly to empower mothers to make informed choices about infant feeding.