Abstract
BackgroundIn Canada, 91% of all mothers initiate breastfeeding, but 40–50% stop by 6 months and only 34% breastfeed exclusively for 6 months, with lower rates among socially and/or economically vulnerable women. The Canada Prenatal Nutrition Program (CPNP) aims to support breastfeeding among vulnerable women, but there is no formal framework or funding for sites to integrate proactive postnatal breastfeeding support. This research aimed to i) describe infant feeding practices among clients of one Toronto CPNP site using charitable funds to offer a lactation support program (in-home lactation consultant visits, breast pumps); ii) determine whether breastfeeding outcomes at 6 months differ based on maternal sociodemographics and food insecurity; and iii) assess utilization of the lactation support program.MethodsInfant feeding practices were collected prospectively at 2 weeks, 2, 4 and 6 months postpartum via telephone questionnaires (n = 199). Maternal sociodemographics were collected at 2 weeks and food insecurity data at 6 months postpartum. Program monitoring records were used to determine utilization of the lactation support program.ResultsNinety-one percent of participants were born outside of Canada; 55% had incomes below the Low-Income Cut-Off; and 55% reported food insecurity. All participants initiated breastfeeding, 84% continued for 6 months and 16% exclusively breastfed for 6 months. Among breastfed infants, ≥76% received vitamin D supplementation. Approximately 50% of infants were introduced to solids before 6 months. Only high school education or less and food insecurity were associated with lower breastfeeding rates. Overall, 75% of participants received at least one visit with a lactation consultant and 95% of these received a breast pump.ConclusionsThis study provides initial evidence that postnatal lactation support can be delivered within a CPNP site, with high uptake by clients. While all participants initiated breastfeeding and 84% continued for 6 months, adherence to the recommended 6 months of exclusive breastfeeding was low. Further research is needed to better understand the barriers to exclusive breastfeeding and how to support this practice among vulnerable women.Study registered at clinicaltrials.gov as NCT03400605.
Highlights
Introduction to solidsWithin the study period, 84% of infants were introduced to solids, 66% of whom received an iron-rich food source as their first food
This study provides initial evidence that postnatal lactation support can be delivered within a Canada Prenatal Nutrition Program (CPNP) site, with high uptake by clients
Women in this study experienced multiple vulnerabilities known to be associated with reduced breastfeeding, yet we found few differences in assessed breastfeeding outcomes at 6 months based on maternal sociodemographics
Summary
Introduction to solidsWithin the study period, 84% of infants were introduced to solids, 66% of whom received an iron-rich food source as their first food. This research aimed to i) describe infant feeding practices among clients of one Toronto CPNP site using charitable funds to offer a lactation support program (in-home lactation consultant visits, breast pumps); ii) determine whether breastfeeding outcomes at 6 months differ based on maternal sociodemographics and food insecurity; and iii) assess utilization of the lactation support program. In accordance with World Health Organization (WHO) guidance, Health Canada recommends that infants receive exclusive breastfeeding (EBF) for their first six months of life, are introduced to iron-rich complementary foods (e.g. solids) around this time and continue to be breastfed for up to two years and beyond [9, 10]. The social determinants of health negatively impact breastfeeding practices wherein vulnerable women (e.g. socially and/or economically disadvantaged), including those with low income and education, single parents and adolescents, have lower breastfeeding rates [12,13,14]. There is evidence from CCHS data that the duration of exclusive breastfeeding is lower among those living in food insecure households and qualitative studies suggest that food insecurity compromises breastfeeding practices in Canada [15, 16]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
