Academic journal article Canadian Journal of Public Health

Overcoming Barriers to Breastfeeding: Suggested Breastfeeding Promotion Programs for Communities in Eastern Nova Scotia

Academic journal article Canadian Journal of Public Health

Overcoming Barriers to Breastfeeding: Suggested Breastfeeding Promotion Programs for Communities in Eastern Nova Scotia

Article excerpt


The 1994 rate of initiation of breastfeeding in eastern Nova Scotia was 41%. The purpose of this study is to assess both perceived barriers to breastfeeding as well as the need for programs to promote breastfeeding in this region. Seventy randomly selected subjects (67 F, 3 M) responded to a questionnaire about regional breastfeeding practices. Results showed that perceived barriers to breastfeeding included lack of knowledge about breastfeeding management (35.8%) and lack of support (29.9%). Barriers to exclusive breastfeeding for 6 months included going back to work (76.5%) and lack of support (39.2%). To promote exclusive breastfeeding for 6 months, participants recommended access to: prenatal classes (98.5%), nurse follow-up following hospital discharge (95.3%), and availability of lactation consultants (88.3%). When proposed promotion programs were implemented, breastfeeding initiation increased to 60.5% and duration rates increased to 4 months (90.2%). Regional barriers to breastfeeding can be partly alleviated through educational and support programs.

Since 1979, the Canadian Paediatric Society and the World Health Organization (WHO) set the goal to promote and encourage breastfeeding.1-6 These two organizations recommend exclusive breastfeeding as the most appropriate method of infant feeding to about 6 months of age, followed by breastfeeding supplemented with complementary food for up to 2 years and beyond.1-5 Throughout the last two decades, the rate of initiation of breastfeeding in Canada has fluctuated from 64% in 1979 to 73% in 1994.(7-11) In Canada, the number of infants exclusively breastfed to 4 months duration rose from 37% in 1979 to 60% in 1994, while infants exclusively breastfed to 6 months rose from 27% in 1979 to 30% in 1994.(7,11)

In 1994-95, Atlantic Canada had the lowest breastfeeding initiation rates in the country (53%).11 Rates of duration of breastfeeding were about one third to one half the national average.12-15 Matthews and colleagues reported a breastfeeding initiation rate of 42.9% in Newfoundland and Labrador declining to about 20% at 3 months and 11.4 % at 6 months.12 In New Brunswick, earlier reports showed a breastfeeding initiation rate of 56% which declined to 31% at 3 months and 16% at 6 months.13 In 1994, 62.5% of new mothers in Nova Scotia initiated breastfeeding following birth.14 At 12 weeks, 48-59% of infants were given either exclusive breast milk (breast milk and water or vitamin drops only) or a combination of breast milk complemented with other forms of milk, fluid or solid foods respectively.14 Throughout Nova Scotia, about 18.8% of infants were exclusively breastfed at 5 to 7 months while 16.8% were fed breast milk along with complementary foods.14

In eastern Nova Scotia, however, the 1994 rate of initiation of breastfeeding was only 41%.14,15 There were no data on the regional rates of duration of breastfeeding. So why are the rates of breastfeeding lower in eastern Nova Scotia than in other parts of the province and what can be done to improve these rates? Research has shown that regional factors influencing increased duration of exclusive breastfeeding in Atlantic Canada were maternal age, level of education and support, income level, attendance at prenatal classes,12-14 and returning to work.13,14

The purposes of this study were to: a) determine the perceived barriers to both breastfeeding in general and exclusive breastfeeding for up to 6 months duration in eastern Nova Scotia, and b) empower participants to make suggestions for community- and hospital-based programs that would improve these rates. Finally, data are also presented on the impact of implementing suggested breastfeeding promotion programs on the improvement in breastfeeding initiation and duration rates in eastern Nova Scotia.


Subjects living in the Counties of Antigonish, Guysborough, Richmond, and Inverness in eastern Nova Scotia were chosen by systematic random sampling to participate in the study. …

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