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Int Breastfeed J. 2018 Apr 10;13:15. doi: 10.1186/s13006-018-0157-x. eCollection 2018.

Effect of maternal country of birth on breastfeeding practices: results from Portuguese GXXI birth cohort.

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1EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal.
2Department of Community Medicine, College of Medicine, Kaduna State University, Kaduna, Nigeria.
3Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.



Maternal country of birth has been associated with perinatal health outcomes but less is known regarding breastfeeding practices in contemporary European settings. This study investigated effect of maternal country of birth on breastfeeding initiation and duration by comparing native Portuguese and migrant mothers.


We analyzed data of 7065 children of the Generation XXI (GXXI) birth cohort recruited at birth (2005-06) and followed-up 4 years later. Logistic regression was used to assess the effect of maternal country of birth on breastfeeding initiation. Kaplan-Meier estimate was used to compare breastfeeding duration by maternal country of birth and length of residence by migrant mothers in Portugal.


Breastfeeding initiation and the type of breastfeeding practice were similar for native Portuguese and migrant mothers. The migrants had significantly higher median duration in months of any breastfeeding (Odds Ratio [OR] 6.0, 95% Confidence Interval [CI] 5.4,6.6) and exclusive breastfeeding (OR 4.0, 95% CI 3.8,4.2) than native Portuguese mothers (OR 4.0, 95% CI 3.8,4.2 and OR 3.0, 95% CI 2.9,3.0). Migrant mothers who resided in Portugal for either ≤5 years (OR 5.0, 95% CI 3.9,6.1 and OR 4.0, 95% CI 3.8,4.2) or >  5 years (OR 6.0, 95% CI 5.5,6.5 and OR 4.0, 95% CI 3.7,4.3) years had similar duration of any breastfeeding or exclusive breastfeeding, in both cases higher than the native Portuguese mothers. No significant differences were found when world regions were compared.


Maternal country of birth does not influence breastfeeding initiation and type of feeding practice. However, migrant mothers have longer breastfeeding duration of either exclusive or any breastfeeding, which was not changed by length of residence in Portugal.


Breastfeeding; Duration; Initiation; Maternal country of birth; Portugal

Conflict of interest statement

The project Generation XXI received ethical approval by the Ethical Committee of São João Hospital/ University of Porto Medical School and complies with the Helsinki Declaration and the current national legislation. The Portuguese Data Protection Authority also approved the study [20]. Written informed consent was obtained from all participants during baseline and subsequent follow up re-evaluations.Not applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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