Learning from Mothers, Grandmothers and Great Grandmothers about Breastfeeding in the Northwest Territories

Regions: Inuvialuit Settlement Region, Gwich'in Settlement Area, Sahtu Settlement Area, North Slave Region, South Slave Region

Tags: health, social sciences, traditional knowledge, breast feeding

Principal Investigator: Moffitt, Pertice M (7)
Licence Number: 16171
Organization: Aurora Research Institute
Licenced Year(s): 2017
Issued: Sep 06, 2017
Project Team: TBA (Graduate Student , TBA), TBA (Student Research Assistant, Aurora College)

Objective(s): To collect data on breastfeeding initiation and duration rates; to learn about past practices and traditional knowledge about caring for babies; to learn about the determinants of breastfeeding; and to create a health promotion video to encourage breastfeeding and enable knowledge translation.

Project Description: The objectives of this research project are to:
1. conduct retrospective chart audits to provide epidemiological data on breastfeeding initiation and duration rates;
2. conduct focus group meetings with grandmothers and great-grandmothers to learn about past practices and traditional knowledge about caring for babies;
3. conduct semi-structured interviews with mothers to learn about the determinants of breastfeeding; and,
4. informed from the above data, create a health promotion video to encourage breastfeeding and enable an enable knowledge translation.

Convenience sampling will be used to conduct retrospective chart audits to provide data on the breastfeeding initiation and duration rates for one full year (January to December 2016) in the four birthing locations in the NWT (Stanton Territorial Hospital, Inuvik General Hospital, Hay River Hospital and Fort Smith Community Health Centre). Data will be recorded using a paper data abstraction tool. One audit tool will be completed for each birth included in the sample. An anonymous coding system will be created so there are no identifiable factors. Measures that will be collected are mother’s ethnicity, parity, gestation, and year of birth; apgar score, birthweight and sex of the infant, type of delivery, if the mother was intending to breastfeed on admission, if breastfeeding was initiated, if supplementation was given, and if so if it was water or formula. The retrospective chart audits will include all births that occurred in the NWT for the 2016 year (approximately n=750). Inclusion criteria is all territorial women giving birth in 2016.

The six month follow-up will be conducted with the Public Health Nurses in Yellowknife and Inuvik and with nurses and midwives in the communities selected. This will provide a means to begin monitoring and sustained statistics to see if this project and future initiatives improve the uptake of breastfeeding. Eventually, it is foreseeable that this data can be captured in the electronic record and reports easily accessed.

Semi-structured interviews will take place face-to-face or over the telephone to meet the needs of women from all communities, for example in the Beaufort Delta Region or the Sahtu. The aim of the interview is to capture determinants of breast feeding for mothers in the NWT. Purposeful and snowball sampling will be used to recruit participants. Interviews will be from 30 to 90 minutes and will follow a semi-structured format. The research team will strive to interview 10 mothers in each cultural/community group with a potential participant number of 50 mothers. All women feeding an infant under one year of age will be included whether they are breast or bottle feeding so that a broad understanding of the determinants are gleaned. Participants will be offered the opportunity to receive a copy of the transcript of her interview to add or delete data. Voluntary consent for photographs and filming will be obtained and stored in a separate file and password protected. The research team will hold focus groups in Inuvik, Tulita, Hay River and Fort Smith.

Data analysis will be iterative with data collection and a process of thematic analysis will be used. Relevant literature will be integrated within the findings. The three data collection methods will be triangulated to provide the foundation for the video and booklets translated into local languages.

Elders will be involved on the Advisory Circle of Knowledge Keepers (6 Elders from the regions where data will be collected). Feeding our Babies Steering Committee from the Department of Health and Social Services. A graduate Student from Aurora College will be a research assistant. Focus groups will be held with elders in four communities of the NWT.

Everyone who participates in the research will be given the opportunity to receive a copy of their transcript to validate and add to. A plain language summary will be created and sent to each community, and a video will be created and circulated across the north.

The fieldwork for this study will be conducted from September 10, 2017 to December 31, 2017.