Infant Feeding Research in

Newfoundland and Labrador

Leigh Anne Newhook MD, FRCPC

• To introduce the Baby-Friendly Council of NL Research

Working Group and its purpose

• To gain an understanding of the infant feeding culture in NL

and an awareness of why breastfeeding rates are low

• To learn highlights of our research results to date

• To learn how we are using research to inform our Baby-

Friendly Council strategy

Learning Objectives:

Breastfeeding Rates by Health

Authority in NL

Health Region 2012 2016

Eastern Health 70 % 78 %

Central Health 64 % 65 %

Western Health

61 % 65 %

Labrador Grenfell

72 % 77 %

NL 68 % 75 %

Source: Perinatal Program NL, 2016

Exclusive BF for Six Months

• NL EBF for 6

months: 16%

• Canadian EBF: 26%

Source: Statistics Canada, CCHS 2014 Photo courtesy of Russell Wyse

o by 2025, Newfoundland and Labrador’s

breastfeeding initiation rate will increase by 7%

(to ≈ 80%).

o current NL initiation rate: 72.7%

oCanadian rate: 90%

Baby-Friendly Council of NL

Strategic Goals

• To establish breastfeeding as

the cultural norm for infant

feeding

• Increase 6-month EBF to

20%

• Increase EBF at hospital

discharge to 60%

• designated Baby-Friendly

maternity facilities and

community health services in

each RHA Photo courtesy of Rhonda Roebothan

Baby-Friendly Council Of NL: Structure

Baby-Friendly Initiative

Central Regional

Breastfeeding Committee

Eastern Regional

Breastfeeding Committee

Labrador/ Grenfell Regional

Breastfeeding Committee

Western Regional

Breastfeeding Committee

Communication and Strategy

Public Education and Awareness

Research

The Research Working Group

• A multidisciplinary team of

researchers, research users,

healthcare professionals, healthcare

decision makers and policy makers

Who are we?

• www.babyfriendlynl.ca

Students:

• Dr. Samantha Woodrow

• Susan Warren

• Nouf Alkusayer

• Sharmeen Chowdhury

• Alicia Taylor

• Dr. Laurie Twells• Dr. Leigh Anne Newhook • Dr. Janine Woodrow • Beth Halfyard• Nicole Gill • Heidi Boyd • Dr. William Midodzi• Dr. Julie Emberley• Dr. Anne Ryan-Drover• Dr. Rana Aslanov• Dr. Tiffany Lee• Dr. Julie Temple-Newhook

www.babyfriendlynl.ca

Primary Goal

• To develop a comprehensive body of

research including a social strategy to

protect, promote and support

breastfeeding in NL

www.babyfriendlynl.ca

This is to be achieved using: 1. Quantitative research methods

2. Qualitative research methods

3. Social Strategy - interact and engage the public

in a discussion on infant feeding

Research Working Group

Objectives • To accurately measure the rates of BF: intent,

initiation and duration

• To collect reliable information on why women choose specific infant feeding methods

• To gain a better understanding of why breastfeeding rates are so low in this province

• To inform the development of interventions to improve BF rates

• Improve the health and well-being of all mothers and babies in NL

Research Program in Infant Feeding

mothers’ attitudes, beliefs

and values regarding infant

feeding

Grandmothers’Perspective

Phase 1Recruitment of

pregnant mothers in 3rd trimester

Phase 2Follow-up with

mother 1-3 mthspost delivery

Phase 3Follow-up with

mother 6-12 mthspost delivery

Phase 4Follow-up with

mother and childOne year of age(GE, AOM, LRTI)

Meeting with Aboriginal stakeholders

Labrador

LabradorAboriginal-Nunatsiavut,

NunatuKavut, Innu

Intervention studies

Follow-up study with mother and child at 4-5

years of age

Qualitative StudiesQuantitative Study

The FiNal StudyFuture Research

Perinatal experiences

Tongue-tie

Published topics

• Infant feeding and preschool obesity• Reasons why mothers chose formula feeding• Experience of grandmothers • Knowledge and attitudes of pregnant women

(IIFAS)• Poverty and breastfeeding: comparing

determinants of early breastfeeding cessation• Determinants of nonmedically indicated in-

hospital supplementation • Omega fatty acids and breastmilk

Current projects

• Clinical applicability of IIFAS

• Infant “health services use” and infant feeding

• Systematic review of infant feeding and respiratory infection

• Parental and provider experiences of infant feeding support

• Skin-to-skin and C-Sections

• Family experiences and tongue-tie

• Human milk supplementation in the NICU

Future topics

• Epidemiology of tongue-tie

• Influence of the formula industry in NL

• Post-partum depression and infant feeding

• Intervention studies

– Prenatal education

– skin-to-skin and vulnerable women

• *Patient-oriented research

Knowledge Translation/Social

Strategy

• Local Research Symposia (2009, 2011, 2016)

• Presentations to government policy makers

• NLCHI Breastfeeding Fast Facts

• Baby-Friendly Council Newsletter

• Collaboration with MUN student researchers

• Conference presentations

• Pediatric Grand Rounds

www.babyfriendlynl.caCafé Scientifiques

(CIHR funded) ◦ 2011 - St. John’s

◦ 2012 - Corner Brook

◦ 2013 - Gander

◦ 2014 - Labrador

www.babyfriendlynl.ca

Media-public interviews/print• CBC morning shows

• CBC Cross Talk

• Rogers “Out of the Fog”

• Articles in local papers

• University publications

• Social media: babyfriendlynl.ca

Baby-Friendly Council Of NL: Structure

Baby-Friendly Initiative

Central Regional

Breastfeeding Committee

Eastern Regional

Breastfeeding Committee

Labrador/ Grenfell Regional

Breastfeeding Committee

Western Regional

Breastfeeding Committee

Communication and Strategy

Public Education and Awareness

Research

www.babyfriendlynl.ca

Photo courtesy of Aimee Chaulk

Funding

Committee Members

• To introduce the Baby-Friendly Council of NL Research

Working Group and its purpose

• To gain an understanding of the infant feeding culture in NL

and an awareness of why breastfeeding rates are low

• To learn highlights of our research efforts to date

• To learn how we are using research to inform our Baby-

Friendly Council strategy

Learning Objectives: