Map of Simcoe Muskoka

Pregnancy and Before

Breastfeeding Duration

Overall
By Maternal Age
By Parity
By Gestational Age
By Birth Type By Income
Technical Notes

Health Canada recommends that children are fed only breast milk until the age of six months, with complementary foods added at that time and continued breast milk to two years and beyond.  Breast milk is important for the nutrition, immunologic protection, growth, and development of infants and toddlers. This recommendation is  associated with the greatest protection against major health problems for both breast milk parents and infants.  Breast milk duration is the length of time that an infant is fed breast milk, and for this analysis, it is measured at two, four and up to six months of age. For more information on how to breastfeed and where to find support, see the health unit’s website on breastfeeding.

The breast milk duration rates indicate that most infants born to Simcoe Muskoka parents are not meeting this national and international recommendation.  Multiple factors affect breast milk duration rates including intrapartum factors (type of birth, skin-to-skin contact, supplementation), postpartum factors (available supports and services), demographics (maternal and gestational age) and social determinants of health such as income. The data on this page are from the SMDHU Infant Feeding Surveillance system.

Overall

In 2018, the Simcoe Muskoka exclusive breast milk duration rate up to six months was 19.6% (16.1%–23.7%), which is similar to previous years. An additional 7.1% (5.1% - 10.0%) of infants were fed exclusively breast milk up to six months after supplementing at least once prior to two months, which is classified as “returned to only breast milk”. When these groups are combined, approximately one quarter (26.7%) of infants are fed exclusively breast milk up to six months.

Almost 60% (58.8% (54.0 – 63.4%)) of infants were fed 'any' breast milk up to six months. This includes those who are feeding exclusively breast milk, those who have “returned to only breast milk”, and those who are combination feeding (ie. breast milk and a substitute).

BFDuration_overall

By Maternal Age

Analysis of local data showed that maternal age group is independently associated with exclusive breast milk duration (ie. if all other factors were held constant).  The figure below shows that babies born to parents in the middle age group (25-34 years) have a higher exclusive breast milk duration rate than babies born to the younger (up to 24 years) and older (35 years and older) age groups at two, four and up to six months.

BFDuration_MatAge

By Parity

Analysis of local data showed that parity (number of previous births) is independently associated with exclusive breast milk duration (ie. if all other factors were held constant). The figure below shows that babies born to second time parents (parity of two) have a higher exclusive breast milk duration rate than those born to first time parents. Despite their lower intention rates, second time parents have higher exclusive initiation and duration rates compared to first time parents, likely because intention is informed by the experience with the previous baby and therefore intention is a more accurate predictor of feeding type with second babies.

BFDuration_Parity

By Gestational Age

Analysis of local data showed that gestational age category is independently associated with exclusive breast milk duration (ie. if all other factors were held constant).  The figure below shows that babies born at 37 or more weeks gestation have a higher exclusive breast milk duration rate than premature babies (up to 37 weeks gestation) at two, four and up to six months.

BFDuration_GA

By Birth Type

Analysis of local data showed that birth type is independently associated with exclusive breast milk duration (ie. if all other factors were held constant).  The figure below shows that babies delivered vaginally have a higher exclusive breast milk duration rate than those delivered by caesarean section at two, four and up to six months.

BFDuration_BirthType

By Income

Analysis of local data showed that income category is independently associated with exclusive breast milk duration (ie. if all other factors were held constant).The fig ure below shows that babies born to families with an annual after tax income of $60,000 or more have a higher exclusive breast milk duration rate than those with a lower income at two, four and up to six months.

BFDuration_Income

Technical Notes

There are two sources of local data for infant feeding at initiation:  BORN and SMDHU Infant Feeding Surveillance System.  The “any” breast milk rate at initiation is very similar between the two sources, and therefore also the complementary “no breast milk” rates at initiation.  However, the two sources differ in the proportion of people who were exclusively breast milk at initiation and those who were combination feeding (breastmilk and a substitute).  BORN exclusive initiation rates are approximately 10% higher than SMDHU Infant Feeding Surveillance exclusive initiation rates.

Possible explanations for this difference include recall bias of SMDHU Infant Feeding Surveillance respondents who may not accurately remember what baby was fed from birth to discharge, and/or breast milk substitute fed to babies in hospital that is not being reflected in BORN. The sampling frame for surveillance is all of those who have a completed HBHC screen received by SMDHU so if those people are systematically different than those who do not have a completed screen, this could create a biased sample as well.