Download Notable Trends within the Province

FACT SHEET
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Breastfeeding in Ontario
Notable Trends within the Province
In order to gain a greater understanding of breastfeeding in Ontario, breastfeeding data was
retrieved from the Better Outcomes Registry and Network (BORN) Ontario database (2012/13).
The information retrieved highlighted the impact of factors on exclusive breastfeeding rates
among mothers who gave birth to live, full-term infants in the province of Ontario:
• Individual and neighbourhood demographics.
• Childbirth outcomes.
• Prenatal care.
• Health status.
• Substance use.
This factsheet highlights noteworthy trends in the provincial data. All statistics presented in this
factsheet refer to exclusive breastfeeding at hospital discharge unless otherwise indicated.
Some data in this fact sheet is presented for all of Ontario and some data is presented for specific
Local Health Integration Networks (LHINs). Ontario LHINs are not-for-profit corporations
who work with local health providers and community members to determine the health service
priorities of their regions. Funded by MOHLTC, LHINs plan, integrate and fund local health
services. There are 14 LHINs in Ontario (www.lhins.on.ca).
A more detailed summary of information can be found in Health Nexus’ publication Populations
with Lower Rates of Breastfeeding: A Summary of Findings.
Notable Trends within the Province
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FACT SHEET
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Maternal Age
Within Ontario, being a teenage mother is generally associated with lower rates of exclusive
breastfeeding (50.2% compared to a provincial average of 61.8%).
This difference tends to be especially pronounced among teenage mothers living in both the
Champlain and North West LHINs. When compared to 30-34 year olds (who have the highest
rate of breastfeeding within both LHINs), teens in the Champlain LHIN are 20.9% less likely to
breastfeed and teens within the North West LHIN are 35.3% less likely to breastfeed.
However, among teenage mothers within the Central West LHIN, the opposite effect has been
found. Teenage mothers have been found to have the highest rate of breastfeeding of all age
groups (57.6%), while other age groups have rates of breastfeeding that range from 44.5%
(among women age 40 and older) to 55.6% (among 25 to 29 year olds).
Percent Exclusive Breastfeeding at Discharge by Age of Mother
80%
70%
60%
50%
40%
30%
20%
10%
0%
Ontario
Less than 20
North West
20 – 24
25 – 29
Champlain
30 – 34
Central West
35 – 39
40+
Parity
After giving birth, Ontario women who have only one child and women who have more than one
child are almost equally as likely to breastfeed (61.4% vs 61.5%).
Unemployment
Within Ontario, neighbourhoods with lower rates of unemployment have been found to have
higher rates of exclusive breastfeeding in all LHINs (65.3%).
When neighbourhoods are stratified according to unemployment level, compared to the
provincial average, all quartiles of neighbourhoods within the Erie St. Clair LHIN, have lower
rates of breastfeeding.
Notable Trends within the Province
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Income
Consistently across all 14 LHINs in Ontario, neighbourhoods with higher median household
incomes have been found to have higher rates of exclusive breastfeeding.
When neighbourhoods are stratified according to income level, the Ontario neighbourhoods with
the lowest incomes have a breastfeeding rate of 54.7% and those with the highest incomes have a
breastfeeding rate of 68.4%.
Immigration
Within Ontario, neighbourhoods with the highest proportion of immigrants tend to have lower
rates of exclusive breastfeeding.
However within the South East LHIN, this trend is reversed. Within this LHIN, the neighbourhoods with the lowest concentrations of immigrants were found to have the lowest rates of
breastfeeding (57.9%) and those with the highest concentration of immigrants were found to
have the highest rates of breastfeeding (76.5%).
Percent Exclusive Breastfeeding at Discharge by Neighbourhood Concentration of Immigrants
80%
70%
60%
50%
40%
30%
20%
10%
0%
Ontario
1 (Lowest)
South East
2
3
4 (Highest)
Visible Minorities
Within the province, the neighbourhoods with the highest concentration of visible minorities
tend to have lower rates of exclusive breastfeeding.
However, similar to immigration within the South East LHIN, this trend is reversed. The
neighbourhoods with the highest concentrations of visible minorities had the highest rates of
breastfeeding (74.1%) and those with the lowest concentrations of visible minorities had the
lowest rates of breastfeeding (57.6%) in 2012/13.
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Mode of Delivery
With respect to exclusive breastfeeding, within Ontario there is a pronounced difference between
women who deliver by cesarean and those who have vaginal deliveries (48.0% vs 66.5%).
Types of Vaginal Birth
Ontario women who have assisted vaginal births and those who have spontaneous vaginal births
have similar rates of exclusive breastfeeding (61.1% respectively).
Perineal Lacerations
Within Ontario, the rate of exclusive breastfeeding among women who had no perineal
lacerations, or had 1st or 2nd degree lacerations following birth (66.6%) is comparable to that
of women who had 3rd, 4th or cervical lacerations (65.9%).
Pain Management during Labour and Birth
Women in Ontario who use pain management during labour and birth, including epidurals,
narcotics, inhalants and non-medical pain relieving methods have lower rates of exclusive
breastfeeding (62.5%) than women who receive no pain management during childbirth (70.4%).
Due to some missing data, particularly in larger centres, this information should be treated
with caution.
In the North East LHIN the difference between both groups (13.3%) was most pronounced.
Percent Exclusive Breastfeeding at Discharge Related to Pain Management
80%
70%
60%
NO
NO
YES
50%
YES
40%
30%
20%
10%
0%
Ontario
North East
Notable Trends within the Province
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FACT SHEET
Prenatal Health Care Provider
1
Percent Exclusive Breastfeeding
at Discharge by Health Care Provider
Within Ontario, 83.3% of women who
receive prenatal care from a midwife
breastfeed exclusively at hospital discharge.
100%
Women who receive prenatal care from
other providers (such as obstetricians, family
physicians, or nurses) are much less likely
to breastfeed exclusively than those who
receive care from a midwife (58.7%).
80%
Midwife
60%
Other Prenatal
Care Provider
40%
20%
0%
Ontario
Diabetes in Pregnancy
Within Ontario, 62.8% of women without diabetes during pregnancy breastfeed exclusively, while
only 43.7% of women with diabetes during pregnancy breastfeed exclusively after delivery.
Compared to the provincial average, women within the Waterloo Wellington LHIN who have
diabetes during pregnancy are much more likely to breastfeed exclusively after delivery (66.1%).
Women within the North Simcoe Muskoka LHIN who have diabetes during pregnancy are also
much more likely to breastfeed exclusively after delivery (60.3%).
However, with an exclusive breastfeeding rate of 28.8%, women with diabetes during pregnancy
living in the South East LHIN are much less likely to breastfeed exclusively when compared to
the provincial average.
Percent Exclusive Breastfeeding at Discharge Related to Maternal Diabetes
80%
70%
60%
50%
40%
30%
20%
10%
0%
Ontario
Waterloo/
Wellington
NO
South East
North Simcoe/
Muskoka
YES
Notable Trends within the Province
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Mental Health Conditions
Within Ontario, women without mental health conditions and women who have mental health
conditions have similar breastfeeding rates (61.8% vs 59.3%).
However, there are considerable differences between LHINs. In some LHINs slightly more
women with a mental health condition breastfed exclusively, in other LINS there was hardly
any difference between both groups. Some LHINs had large differences of up to 18.5 percentage
points (see graph below for details).
Percent Exclusive Breastfeeding at Discharge by Maternal Mental Health Concerns
80%
70%
60%
50%
40%
30%
20%
10%
0%
Ontario
Waterloo/
Wellington
HNHB
North
Simcoe/
Muskoka
NO
North
East
South
East
North
West
YES
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Substance Use
Following delivery, there is a large difference between the rates of breastfeeding among women
who use drugs and illicit substances, not including alcohol use during pregnancy and those who
do not (42.1% vs 61.9%).
Smoking
Within Ontario, women who do not smoke during pregnancy are more likely to breastfeed than
those who smoke throughout their pregnancy (63.3% vs 47.5%).
This difference is especially pronounced within the North Simcoe Muskoka LHIN where women
in both groups have higher breastfeeding rates than the provincial average, but the difference
between groups is wider. Women who do not smoke during pregnancy have an exclusive
breastfeeding rate of 74.1%, and women who smoke during their entire pregnancy are almost
20% less likely to breastfeed exclusively with a rate of 54.9%.
What Can Service Providers Do?
While the statistics presented in this factsheet highlight noteworthy trends within the provincial
data, they also highlight differences between LHINs and within LHINs.
Service providers should explore their own communities in order to identify community specific,
breastfeeding related strengths and weaknesses and develop effective strategies to improve
breastfeeding.
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References
Best Start Resource Centre. (2014). Populations with Lower Rates of Breastfeeding: A Summary
of Research Findings. Toronto, Ontario, Canada: author.
BORN Ontario1, 2014. Breastfeeding data for 2011/12. Data requested from: www.bornontario.ca
1
This report is based in part on data provided by Better Outcomes Registry and Network (BORN) Ontario, a provincial
program housed at the Children’s Hospital of Eastern Ontario. The interpretation and conclusions contained herein do not
necessarily represent those of BORN Ontario. Data to inform this report came from the historical Niday Perinatal Database
and from the new BORN Information System (BIS).
This document has been prepared with funds provided by the Government
of Ontario. The information herein reflects the views of the authors and is
not officially endorsed by the Government of Ontario.
2014
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