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Health Unit Profiles
Indicators
» Group A - Population Health
   Indicators
 –  Teen Pregnancy
 –  Low Birth Weight
 –  Breastfeeding Duration
 –  Postpartum Contact
 –  Smoking Prevalence
 –  Youth Lifetime Smoking
     Abstinence
 –  Adult Heavy Drinking
 –  Youth Heavy Drinking
 –  Physical Activity Index
 –  Healthy Body Mass Index
 –  Fruit and Vegetable
     Consumption
 –  Fall-Related Hospitalizations
     Among Seniors
 –  Enteric Illnesses Incidence
 –  Respiratory Infection
     Outbreaks in Long-Term
     Care Homes
 –  Chlamydia Incidence
 –  Immunization Coverage of
     Hepatitis B
 –  Immunization Coverage of
     Measles, Mumps and Rubella
 –  Adverse Water Quality
     Incidents
» Group B - Governance and
   Accountability Indicators
Case Studies
Supporting Documents
Initial Report on Public Health
Breastfeeding Duration
Narrative

The breastfeeding duration rate indicator estimates the proportion of mothers age 15-55 years who breastfed (not exclusively) their last baby (born within the past five years) for a duration of six months or more.

According to the WHO, "breastfeeding is the ideal way of providing young infants with the nutrients they need for healthy growth and development." 37 Breast milk contains the ideal nutritional elements for proper digestion, brain development, and growth. Breast milk transmits a mother’s antibodies to her baby, helping to protect the baby against infections and illnesses. Studies also suggest that breastfeeding may protect infants against allergies and respiratory infections, 38 and may lower rates of type 2 diabetes later in the child’s life. 39 Additionally, breastfeeding forms a bond between a mother and her child that is thought to contribute to the healthy psychological development of the child. 40

Breastfeeding is not only beneficial for infants. Research suggests that breastfeeding may lower rates of certain types of ovarian and breast cancer and reduce the risk of osteoporosis in women who have breastfed. 41

Most new mothers have the potential to breastfeed, giving their newborns breast milk which contains everything they need for a healthy start in life. The public health sector in Ontario helps to promote breastfeeding through:

  • providing prenatal and parenting programs, services and supports
  • distributing information regarding the benefits of breastfeeding through mass media
  • offering breastfeeding support and counselling through phone lines, home visits, groups, and clinics
  • providing referrals to professionals and community programming and services for breastfeeding support and information
  • advocating and assisting in the development of policies to support breastfeeding in the workplace, restaurants, shopping malls and other public places

The data presented in Table 2: Indicators by Public Health Unit for the proportion of mothers in Ontario who breastfed their last baby for a duration of six months or more uses a combination of three sets of Canadian Community Health Survey data, collected over a span of 5 years. Because sample sizes of breastfeeding rates at the public health unit level can be quite small, it was necessary to combine these three sets of data in order to arrive at a stable figure for each public health unit.

Approximately 50% of mothers in Ontario breastfed their last baby for a duration of six months or more (over 3 cycles of the survey). Based on 36 public health units in Ontario, the highest estimated proportion of breastfeeding for six months or more was 65% and the lowest estimate was 31% for mothers who had given birth in the last five years at the time of the surveys.

In Ontario, the proportion of mothers breastfeeding for six months or more for each of the survey periods was as follows:
Canadian Community Health Survey Cycle 2.1 (2003) - 46.7% 42
Canadian Community Health Survey Cycle 3.1 (2005) - 50.8% 43
Canadian Community Health Survey 2007 - 53.1% 44

The indicator results demonstrate that improvements are being made in breastfeeding uptake and that there is more opportunity to encourage and support breastfeeding initiation and duration in Ontario, particularly at a time when hospital based supports for breastfeeding are limited.

Indicator Definition

Definition:

The breastfeeding duration rate indicator estimates the proportion of mothers age 15-55 years who breastfed (not exclusively) their last baby (born within the past five years) for a duration of six months or more.

Data Source(s):

Numerator: Canadian Community Health Survey Cycles 2.1, 3.1 and Canadian Community Health Survey 2007, Statistics Canada, Ontario Share Files distributed by the Ministry of Health and Long-Term Care
Denominator: Canadian Community Health Survey Cycles 2.1, 3.1 and Canadian Community Health Survey 2007, Statistics Canada, Ontario Share Files distributed by the Ministry of Health and Long-Term Care

Formula:

Total weighted number of female respondents age 15-55 years who gave birth in the past five years and who breastfed (non-exclusively) their child for at least six months

Total weighted number of female respondents age 15-55 years who gave birth in the past five years
 
x 100

Notes:

  • This indicator was derived by combining three cycles of the Canadian Community Health Survey (CCHS) in order to obtain reportable and stable data for breastfeeding duration estimates at the public health unit level in Ontario. Simply using one survey to estimate for breastfeeding duration resulted in unstable estimates for the majority of public health units in Ontario, and in many cases the data was unreportable
  • Numerator: MEX_06= Six Months (9), Seven to Nine Months(10), Ten to Twelve Months (11), One year or more (12)
  • Denominator: MEX_01=Has given birth in the last five years (1)
  • Excluded not applicable (96) and not stated (99) responses to MEX_01. Exclusion of women who are currently breastfeeding (MEXC_05=2)
  • PHU 3545 was dropped, 3547 = North Bay, and 3560 = Simcoe in CCHS 2.1 due to amalgamations of public health units
  • There was insufficient sample size to stratify the data for each public health unit for CCHS 2007, and therefore cycles 2.1, 3.1, and CCHS 2007 of the CCHS were combined according to methods outlined by Thomas and Wannell. 129 Both the separate and pooled approaches to combining cycles of the CCHS were considered. The separate approach to combining cycles of CCHS was used in the report
  • As there were not consistent trends over time over the 3 individual estimates for breastfeeding duration, combining the 3 cycles of the CCHS did not diminish the data output in any way

37 World Health Organization. Breastfeeding [Internet]. Geneva: World Health Organization; 2009. Retrieved April 15, 2009 from: http://www.who.int/topics/breastfeeding/en/.
38 Canadian Paediatric Society; Dietitians of Canada; Health Canada. Benefits of breastfeeding to infants in Canada. In: Nutrition for healthy term infants. Ottawa, ON: Minister of Public Works and Government Services Canada; 2005. Retrieved April 15, 2009 from: http://www.hc-sc.gc.ca/fn-an/pubs/infant-nourrisson/
nut_infant_nourrisson_term_3-eng.php#benefits
.
39 Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG. Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of published evidence. American Journal of Clinical Nutrition. 2006;84(5):1043-1054. Retrieved April 15, 2009 from: http://www.ajcn.org/cgi/reprint/84/5/1043.pdf.
40 College of Family Physicians of Canada. Infant feeding policy statement 2004. Toronto, ON: College of Family Physicians of Canada; 2004. Retrieved April 15, 2009 from: http://www.cfpc.ca/local/files/Communications/Health%20Policy/
Final_04Infant_Feeding_Policy_Statement.pdf
.
41 Breastfeeding Committee for Canada. Breastfeeding statement of the Breastfeeding Committee for Canada. Toronto, ON: The Committee; 2002. Retrieved April 15, 2009 from: Thomas S, Wannell B. Combining cycles of the Canadian Community Health Survey. Health Reports. 2009;20(1):53-60. Retrieved June 18, 2009 from
42 Statistics Canada. Canadian community health survey-cycle 2.1 [data file]. Ottawa, ON: Statistics Canada; 2003.
43 Statistics Canada. Canadian community health survey [data file]. Ottawa, ON: Statistics Canada; 2005.
44 Statistics Canada. Canadian Community Health Survey 2007 [data file]. Ottawa, ON: Statistics Canada; 2008.
129 Thomas S, Wannell B. Combining cycles of the Canadian Community Health Survey. Health Reports. 2009;20(1):53-60. Retrieved June 18, 2009 from: http://www.statcan.gc.ca/pub/82-003-x/2009001/article/10795-eng.pdf.

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