# Breastfeeding Duration, Diet, and Sports Engagement in Immigrant Children: A Quantitative Study in the Lisbon Region, Portugal

## TL;DR

The study finds that immigrant children in Lisbon are breastfed longer but face challenges in diet and sports participation compared to non-immigrant children.

## Contribution

The study provides new insights into health behaviors among immigrant preschool children in Portugal, focusing on breastfeeding, diet, and sports.

## Key findings

- Immigrant mothers had higher breastfeeding initiation rates and longer breastfeeding durations compared to non-immigrant mothers.
- Immigrant children consumed fewer fruits and vegetables and were less likely to participate in sports than non-immigrant children.
- Socioeconomic disadvantages among immigrant families were linked to poorer dietary and physical activity outcomes.

## Abstract

Background: Being breastfed, following a healthy diet and staying active during childhood shape health trajectories across the life course, promoting long-term well-being. Despite the growing immigrant child population in Portugal, evidence on these behaviours, particularly among preschool-aged children, remains limited. In this context, this study examines the associations between migrant status and breastfeeding patterns, fruit and vegetable consumption, and participation in sports among children living in the Lisbon Metropolitan Area. Methods: A cross-sectional study nested within a cross-sequential cohort was carried out in the Lisbon region between May 2022 and April 2024. Approximately 760 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected through a face-to-face interview with parents, using a structured questionnaire with information on socioeconomic variables, migration history, breastfeeding habits, and children’s diet (fruit and vegetable consumption) and physical activity. We used parametric and non-parametric tests to compare migrant and non-migrant children. To quantify factors associated with the main outcomes, we estimated a logistic regression model and calculated crude and adjusted odds ratios and their respective 95%CI. Results: Immigrant children were disproportionately represented in socioeconomically disadvantaged families. Breastfeeding initiation rates were higher among immigrant mothers (96.3% vs. 87.6%, p < 0.001). Additionally, immigrant mothers had a longer median duration of any breastfeeding (14 vs. 8 months, p < 0.001) and of exclusive breastfeeding (6 vs. 4 months, p < 0.001). Immigrant children had significantly lower odds of consuming three or more portions of fruit (aOR = 0.700; 95%CI: 0.511–0.959; p = 0.027) and two or more portions of vegetables per day (aOR = 0.489; 95%CI: 0.350–0.684; p < 0.001) compared with non-immigrant children. They were also twice as likely to not engage in sports (aOR = 2.185; 95%CI: 1.512–3.158; p < 0.001). Conclusions: Breastfeeding was better implemented in immigrant children. The findings highlight the need to address social determinants of health and the challenges faced by immigrant families in promoting a balanced diet and sports participation for their children. Multisectoral, culturally appropriate interventions that sustain and promote good breastfeeding practices, improve access to healthy food, and encourage sports are crucial to reducing health inequalities.