A14.6 Baby Friendly Designation_Teresa Cozzella

Strengthening collaboration between Public Health and Primary Health Care to meet Baby-Friendly Initiative Teresa Cozzella June 2014

Conflict of Interest

Disclosure of Commercial Support Presenter Disclosure Presenter:

Teresa Cozzella, Public Health Nurse, IBCLC

Relationships with commercial interests: • Grants/Research Support: None • Speakers Bureau/Honoraria: None • Consulting Fees: None • Other: None

Introduction Breastfeeding exclusively to 6 months and continuing for 2 years or longer is the optimal way to feed infants and children

Baby Friendly Initiative

Step 3: Inform pregnant women and their families about the benefits and management of breastfeeding

Infant Feeding Survey 2010 To assess parenting choices and behaviours related to infant feeding among parents in York Region in the child’s first year of life

York Region Infant Feeding Survey Sub-analysis (2012) Significant finding: The intention to supplement is associated with decreased duration of breastfeeding

Prenatal Breastfeeding Education

Decrease the intention to supplement?

Research Women, especially those who are not sure about breastfeeding, want breastfeeding information during pregnancy (Aurora et al., 2000)

Research Women are more likely to decide to breastfeed and maintain their decision when health care providers’ words and actions demonstrate that they value breastfeeding and breastmilk The Baby-Friendly Initiative: Evidence-Informed Key Messages and Resources (2013)

Prenatal Breastfeeding Class Pilot • Increase breastfeeding knowledge and confidence • Increase awareness of community supports • Increase breastfeeding duration and exclusivity rates

Prenatal Breastfeeding Class Pilot Evaluation

Prenatal Breastfeeding Class Pilot Evaluation Results • 85% were in the standard prenatal classes offered

by York Region • 97% of all participants were first time mothers

Prenatal Breastfeeding Class Pilot Evaluation Results

Prenatal Breastfeeding Class Pilot Evaluation Results

Prenatal Breastfeeding Class Pilot Evaluation Results Intended duration of breastfeeding BEFORE attending Prenatal Breastfeeding Class 18%

32%

Less than 2 weeks 2 - 6 weeks 50%

Intended duration of breastfeeding AFTER attending Prenatal Breastfeeding Class

14% 36%

6 weeks - 3 months 3 - 6 months

6 - 12 months

12 months or more no plan

50%

Evaluation Summary • Overall effective • Increased the level of breastfeeding confidence • Increase in their intention to breastfeed exclusively and for a longer duration

Questions ?

Thank you !

Teresa Cozzella teresa.cozzella@york.ca

References Breastfeeding Practices in Canada: Overview [Internet]; c2010 [cited 2012 July]. Available from: http://www.hc-sc.gc.ca/fnan/surveill/nutrition/commun/prenatal/overview-apercu-eng.php.

Maternal, newborn, child and adolescent health: Breastfeeding [Internet]; c2012. Available from: http://www.who.int/maternal_child_adolescent/topics/child/nutrition/breastfeeding/en/index.html.

Holmes AV, Auinger P, Howard CR. Combination feeding of breast milk and formula: Evidence for shorter breast-feeding duration from the national health and nutrition examination survey. J Pediatr 2011 201108;159(2):186-91.

Azjen I, Fishbein M. Prediction of goal-directed behavior: Attitudes, intentions, and perceived behavioral control. J Exper Soc Psych 1986;22:453-74 Forty-year-old mothers of pre-school children: A profile [Internet]; c2009 [cited 2012 July]. Available from: http://www.statcan.gc.ca/pub/11-008-x/2009002/article/10918-eng.htm Harrell F.E. Regression Modeling Strategies With Applications to Linear Models, Logistic Regression, and Survival Analysis, Springer 2001 Principles and recommendations for infant feeding from birth to six months [Internet]; c2010 [cited 2012 July]. Available from: http://www.hc-sc.gc.ca/fn-an/consult/infant-nourrisson/recommendations/index-eng.php Kronborg H, VĂŚth M. The influence of psychosocial factors on the duration of breastfeeding. Scand J Public Health 2004 06;32(3):210-6 Thulier D, Mercer J. Variables associated with breastfeeding duration. JOGNN 2009;38:259-68 World Health Organization. World health statistics 2009. Geneva: WHO Press; 2009. Report nr 97892 4 156381 9 Whalen B, Cramton R. Overcoming barriers to breastfeeding continuation and exclusivity. Curr Opin Pediatr 2010 10;22(5):655-63