Sociodemographic and Prenatal Predictors of Breastfeeding Initiation and Exclusive Breastfeeding in Hospitals in Nova Scotia
Wang, Xinxin (Emily)
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This report describes the work performed during a 13-week internship in the Reproductive Care Program of Nova Scotia (RCPNS) by Master of Health Informatics (MHI) candidate Xinxin (Emily) Wang in summer 2014. The RCPNS was established as a provincial program by the Nova Scotia Department of Health and Wellness in 1973. The RCPNS collaborates with other members of the Provincial Breastfeeding Steering Committee (PBSC) to provide leadership for the protection, promotion and support of breastfeeding in Nova Scotia. As part of understanding barriers to implementation of the Provincial Breastfeeding Policy, the intern was assigned a research project for Determining Sociodemographic and Prenatal Predictors of Breastfeeding Initiation and Exclusive Breastfeeding in Hospitals in Nova Scotia, which will be used to inform further research of breastfeeding outcomes in Nova Scotia, development of provincial indicators at RCPNS, and potential areas of focus as the Provincial Breastfeeding Policy is implemented. The World Health Organization (WHO) recommends breastfeeding as the means of providing young infants with the nutrients needed for healthy growth and development. Breast milk is also recommended by WHO as the perfect food for the newborn, and the feeding should be initiated within the first hour after birth (WHO, 2002). In 2010, the national average rate of breastfeeding initiation in Canada was 87.3%. However for the same year, the rate in the Atlantic Provinces was 74.8% (Health Canada, 2010) and the rate in Nova Scotia was 80.4% (RCP, 2014a). The Nova Scotia Department of Health and Wellness, RCPNS and the PBSC are working together to provide women with the information and support needed to initiate and continue exclusive breastfeeding. Therefore, a study of predictors of breastfeeding outcomes in the Nova Scotian population is essential to delivering important information to healthcare providers and decision makers. There were three phases within this project: define the gaps in previous literature, design a study based on existing data in the Nova Scotia Atlee Perinatal Database managed by RCPNS, and provide a comprehensive data analysis to inform ongoing and future breastfeeding initiatives. The internship was successfully completed with positive feedback from the supervisor and colleagues at RCPNS. The intern applied Health Informatics skills, especially the knowledge gained from Health Information Flow and Use, Research Methods, and Statistics for Health Information. The intern achieved the overall objective of the project. An analysis determined that sociodemographic factors such as neighbourhood income level, marital status, and maternal age can significantly impact both breastfeeding initiation and exclusive breastfeeding at hospital discharge. The strong prenatal predictors that influence breastfeeding initiation and exclusivity include intention to breastfeed, pre-pregnancy Body Mass Index (BMI), gestational weight gain (GWG) and parity. The findings of this internship project have provided important information to RCPNS that will support introduction of a breastfeeding indictor for the province. The information will be shared with the PBSC and may influence identification of key areas of focus as the newly revised Provincial Breastfeeding Policy is implemented.