Canadian Mothers More Responsive Than Cambodian Peers in a Cross-Cultural Assessment of a Breastfeeding Interaction in the First 6 Months: A Preliminary Assessment

Abstract Objectives Human milk is the sole recommended food for infants for the first 6 months of life. Although determinants and rates of exclusive breastfeeding differ greatly between high- and low-and-middle-income countries, little is known about whether breastfeeding practices, such as feeding responsiveness, differ across cultures. Responsive feeding practices are based on the cues and responses of a caregiver and infant, and are associated with more intuitive eating patterns later in life. This preliminary assessment aims to assess the responsiveness of the maternal-child interactions during breastfeeding of infants less than 6 months old cross-culturally, in both a high- and lower-middle income country. Methods This preliminary analysis includes 10 mother-infant dyads from Nova Scotia, Canada, who have been age-matched (±4 days) to 10 Cambodian dyads recruited in Kampong Thom province, Cambodia. In both settings, a breastfeeding session was video-recorded in the participant's home and videos scored using the validated, 76-item Nursing Child Assessment Satellite Training (NCAST) Caregiver/Parent-Child Interaction Feeding Scale. Results Infants were between 13 and 23 weeks old, and in both groups were 40% firstborn and 40% male. Cambodian mothers (27.3 ± 3.4 years) were significantly younger than Canadian (32.0 ± 2.3; p = 0.002), and the average length of feed in Cambodia was significantly shorter (5.5 ± 1.6 min v. 7.3 ± 1.3 min; p = 0.02). There was no significant difference between Canadian and Cambodian total NCAST scores. However, Canadian mothers scored significantly higher on three of the four maternal NCAST subscales; subscale I (sensitivity to infant's cues, p = 0.03), subscale III (social-emotional growth fostering, p = 0.01), and subscale IV (cognitive growth fostering, p = 0.02) There were no significant differences in scores for NCAST subscales measuring infant's clarity of cues or responsiveness to their mother. Conclusions These preliminary results indicate differences in feeding responsiveness on the part of mothers during breastfeeding in Canada and Cambodia and could inform future programs to optimize the maternal-child feeding interaction. Funding Sources MSVU Internal Grant, Canadian Institute for Health Research, Research Nova Scotia.