France has one of the lowest rates in the world regarding breastfeeding initiation and duration. Few studies have explored breastfeeding practices in France since the middle of the twentieth century, or following from initiation to cessation. The purpose of our study was to determine trends in breastfeeding over the past decades regarding public health recommendations, and to examine mothers’ perceptions about factors known to have an impact on breastfeeding support and cessation. From the NutriNet-Santé cohort, 29,953 parous women (launched in 2009 to study relation between nutrition and health), were included in the present study. Using web-questionnaires, they were asked retrospectively if they had breastfed their youngest child or not, and if so, the duration of exclusive and total breastfeeding. For those who had breastfed, we investigated their perceptions about support at initiation and during the entire breastfeeding period and reasons for breastfeeding cessation. We also asked those who did not breastfeed about their perceptions and reasons for infant formula feeding their youngest child. Analyses were weighted according to the French census data. In the NutriNet-Santé cohort, 67.3% of mothers breastfed their youngest child. The proportion of breastfed children increased over 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. Total and exclusive breastfeeding duration went from 3.3 months and 2.4 months respectively in the 1970s to 5.9 months and 3.2 months respectively in the 2010s. Most mothers felt supported at initiation and during the breastfeeding period. A reported desire to have breastfed longer than two months was 59.5%. 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%), but almost half of them would have liked to have breastfed (45.9%). Breastfeeding duration has increased in the past decades but did not reach the public health recommendations threshold. Targets other than mothers have to be considered for breastfeeding education, like the partner and her environment, to increase breastfeeding practices. The study was registered at ClinicalTrials.gov ( NCT03335644 ).

中文翻译：

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法国 NutriNet-Santé 队列中母乳喂养实践的趋势和母亲的经验

法国是世界上母乳喂养开始率和持续时间最低的国家之一。很少有研究探讨法国自 20 世纪中叶以来或从开始到停止的母乳喂养实践。我们研究的目的是确定过去几十年关于公共卫生建议的母乳喂养趋势，并检查母亲对已知影响母乳喂养支持和停止母乳喂养的因素的看法。本研究包括来自 NutriNet-Santé 队列的 29,953 名经产妇女（于 2009 年启动以研究营养与健康之间的关系）。使用网络问卷，他们被回顾性地询问他们是否给最小的孩子进行了母乳喂养，如果是的话，纯母乳喂养和完全母乳喂养的持续时间。对于母乳喂养的人来说，我们调查了他们在开始和整个母乳喂养期间对支持的看法以及停止母乳喂养的原因。我们还询问了那些没有进行母乳喂养的人，他们对用婴儿配方奶粉喂养他们最小的孩子的看法和原因。根据法国人口普查数据对分析进行加权。在 NutriNet-Santé 队列中，67.3% 的母亲对最小的孩子进行了母乳喂养。母乳喂养儿童的比例在过去几十年中有所增加，从 1970 年代的 55.0% (95% CI 54.3, 55.6) 上升到 2010 年代的 82.9% (82.4, 83.4)。总母乳喂养时间和纯母乳喂养时间分别从 1970 年代的 3.3 个月和 2.4 个月，分别增加到 2010 年代的 5.9 个月和 3.2 个月。大多数母亲在开始和母乳喂养期间都感到得到支持。据报告，希望母乳喂养超过两个月的比例为 59.5%。没有母乳喂养的母亲是自愿选择的（64.3%）。他们不感到内疚 (78.2%) 并且不认为不母乳喂养有问题 (58.8%)，但几乎一半的人希望母乳喂养 (45.9%)。母乳喂养持续时间在过去几十年中有所增加，但并未达到公共卫生建议的阈值。母乳喂养教育必须考虑母亲以外的目标，例如伴侣及其环境，以增加母乳喂养实践。该研究已在 ClinicalTrials.gov (NCT03335644) 上注册。母乳喂养持续时间在过去几十年中有所增加，但并未达到公共卫生建议的阈值。母乳喂养教育必须考虑母亲以外的目标，例如伴侣及其环境，以增加母乳喂养实践。该研究已在 ClinicalTrials.gov (NCT03335644) 上注册。母乳喂养持续时间在过去几十年中有所增加，但并未达到公共卫生建议的阈值。母乳喂养教育必须考虑母亲以外的目标，例如伴侣及其环境，以增加母乳喂养实践。该研究已在 ClinicalTrials.gov (NCT03335644) 上注册。