2014 Infant Feeding in Halton Report

Breastfeeding initiation, duration, exclusivity, supplementation and support collected through the 2014 Halton Infant Feeding Study.

Background

The Halton Region Health Department (HRHD) is committed to promoting, protecting and supporting breastfeeding, and in 2009 received the Baby-Friendly designation. This is the third major Infant Feeding Study completed by the Halton Region Health Department (HRHD). The first study was completed in 2000/01, while the second was done in 2007/08.

Purpose

The primary purpose of the 2014 Halton Infant Feeding Study was to describe breastfeeding initiation, duration and exclusivity and compare it to data collected previously in 2000/01 and 2007/08.

Other objectives of the survey were to determine:

  • why mothers did or did not initiate breastfeeding
  • why mothers continued or stopped breastfeeding
  • why mothers introduced supplementary liquids/solids, and if the introduction of breast milk substitutes was planned
  • when supplementary liquids and solids were introduced to babies
  • impact of socio-demographics and birth interventions on breastfeeding initiation, duration, and exclusivity
  • awareness, use of, and helpfulness of various sources of breastfeeding support

Design

Data for the Halton Region Health Department’s 2014 Infant Feeding Study was collected using a survey distributed to mothers when their babies turned six months old. The survey was conducted primarily online, with a telephone option for mothers who did not want to complete the survey online, or who could not be reached online.

Key Findings

  1. The percent of mothers who initiated breastfeeding in Halton has increased since 2000/01, with 97% of mothers having initiated breastfeeding in 2014 (compared to 90% in 2000/01 and 93% in 2007/08).
  2. The percent of Halton mothers breastfeeding at each time period between one week and six months has increased from 2000/01 to 2014, such that 75% of mothers were breastfeeding at age six months in 2014 (compared to 50% in 2000/01 and 64% in 2007/08).
  3. Mothers who have lower levels of education, mothers who have lived in Canada for less than ten years, and mothers who did not breastfeed their other children were more likely than other mothers to breastfeed for a shorter duration.
  4. The percent of Halton mothers breastfeeding exclusively at each time period between one week and six months has increased from 2000/01 to 2014, with 56% of mothers breastfeeding exclusively at age one week, and 19% at age six months in 2014 (compared to 40% and 1% in 2000/01 and 50% and 12% in 2007/08).
  5. Mothers who have lived in Canada for less than five years and mothers who did not breastfeed their other children were more likely than other mothers to breastfeed exclusively for a shorter time.
  6. Only 39% of mothers gave ‘encouragement from healthcare providers’ as a reason for initiating breastfeeding and only 30% gave it as a reason for breastfeeding to age six months.
  7. ‘Advice from healthcare providers’ is one of the main reasons breastfeeding mothers give for introducing solids (51% introduced solids based on the advice of their healthcare provider).
  8. Supplementation in hospital continues to impact the percent of mothers breastfeeding exclusively in Halton (69% breastfed exclusively at age one week when only home experiences were included compared to 56% when both hospital and home experiences were included).
  9. Just over half (54%) of Halton mothers supplemented with breastmilk substitutes after coming home from the hospital, and the majority of these mothers (70%) supplemented when their baby was less than one week or one week old.
  10. Lack of breastmilk continues to be the primary reason mothers give for supplementing with breastmilk substitutes (64% of breastfeeding mothers gave this as a reason).
  11. Many Halton mothers are continuing to introduce solids before their babies turn six months old (of the 58% of mothers who introduced solids, 72% did so before their babies turned six months old).
  12. Mothers are most knowledgeable about the breastfeeding support provided by nurses at the hospital (95%), hospital breastfeeding clinics (92%), prenatal classes (81%), and healthcare providers (76%). Mothers are most likely to have used breastfeeding support from nurses at the hospital (82%) and hospital breastfeeding clinics (55%).
  13. Knowledge and use of breastfeeding support programs and services provided by the Halton Region Health Department is lower than other sources, with 56% knowing about and 13% having called a Public Health Nurse, 39% knowing about and 6% having used the Halton Breastfeeding Connection, and 30% knowing about and 6% having used HaltonParents.

Recommendations

  1. Continue to work with community partners to improve breastfeeding initiation, duration and particularly exclusivity. Specific actions could include:
    • Continuing to support the Halton Baby-Friendly Initiative (HBFI) through the Halton Region Health Department liaison role.
    • Continuing to support community hospitals as they work towards Baby-Friendly designation, focussing on reducing supplementation in hospital.
  2. Educate parents in the prenatal and postpartum periods about the importance of breastfeeding, in particular about breastfeeding exclusively to age six months. Specific actions could include:
    • Targeting messages about duration prenatally and prior to babies turning three months old, since this is when duration starts to decline.
    • Targeting messages about exclusivity prenatally and just after birth to improve exclusive breastfeeding at home, especially in the first few weeks. Key messages should be developed about perceived lack of breastmilk as a reason for introducing breastmilk substitutes, and strategies for parents when they believe that they do not have enough milk.
    • Targeting messages about introduction of solids prenatally and prior to babies turning four months old, since solids are typically introduced at age four and five months.
  3. Reach out to healthcare providers since they are a critical source of information and support for breastfeeding mothers. Specific actions could include:
    • Encouraging the HBFI to strengthen the physician liaison role and continue education to family practice residents.
    • Including information related to breastfeeding education and support into physician outreach strategies that are developed.
  4. Explore strategies to reach mothers who are breastfeeding for a shorter duration and/or breastfeeding exclusively for a shorter time period, in particular new immigrants and mothers with lower levels of education. Strategies could include:
    • Conducting a Health Equity Impact Assessment (HEIA) to identify barriers to breastfeeding for mothers who are new immigrants and mothers with lower levels of education
    • Looking at opportunities to improve current prenatal and postnatal programming to better reach new immigrants and mothers with lower levels of education, focussing on when duration and exclusivity typically drop off for these mothers.
    • Educating mothers with lower levels of education by incorporating information about breastfeeding into elementary and high school curriculums. This would include supporting the Ontario Public Health Association (OPHA) breastfeeding promotion group, and exploring ways to work on this at a local level.
  5. Share the key findings of the 2014 Infant Feeding Study with stakeholders in Halton such as: local hospitals, the Local Health Integration Network’s, and the Halton Baby-Friendly Initiative.