Grant: Operating Grant: SPOR iCT Rewarding Success - Travel Awards - NL

Newfoundland and Labrador (NL) has the lowest rates of breastfeeding and the highest rates of chronic disease and health care expenditures in Canada. Exclusive breastfeeding to 6 months provides significant health benefits to infants and mothers reducing the risk of infections, sudden infant death syndrome and infant mortality. Mothers benefit with reduced risks of postpartum hemorrhage, ovarian and breast cancer. Increasing breastfeeding rates has the potential for significant cost savings to the health system and society. Despite well-evidenced benefits and costly knowledge and awareness campaigns, breastfeeding to 6 months is not the norm in NL, other provinces or other jurisdictions. Reasons for low rates are complex, with decisions and behavior influenced by organizational factors, settings and individual characteristics. Among all influencing factors, maternal attitudes to breastfeeding are the strongest predictor of initiation and duration. Using the Iowa Infant Feeding Attitude Scale, validated in our population, interventions developed for expectant mothers will address identified barriers. Informed by a decade of research in NL, an innovative eHealth program will be developed that is theory-driven, technologically-based and targeted at the individual to empower and enable behaviour change. Interventions will be informed by patient partners and knowledge users. We will evaluate the effect of the intervention using a randomized controlled trial. Participants recruited during pregnancy and categorized based on attitude scores will be randomly allocated to the eHealth program or usual care and followed for 6 months after delivery. The study population is biologically-defined, however as infant feeding and parenting are gender-related variables (e.g., marital status, education), a gender-based analysis will be considered. This research aligns with the provincial priority in NL's Way Forward Roadmap (2016), to increase breastfeeding initiation by 7% by 2025.