Lactation supports implemented within the Canada Prenatal Nutrition Program: findings from a national survey

Supporting breastfeeding is integral to the Canada Prenatal Nutrition Program (CPNP), although details on lactation support implementation are limited. This research aimed to assess lactation support delivery by CPNP sites across Canada, excluding Quebec, and how the COVID-19 pandemic affected services.

From May to July 2023, we conducted a cross-sectional survey; 207 sites were invited to participate. We investigated the types of lactation supports delivered; how and by whom; and the role of site characteristics (locality, Community Action Program for Children funding, breastfeeding clinic on-site, primary healthcare facility on-site) and funding sources (CPNP only, CPNP and other funds, other funds only) on lactation support provision.

All respondents (n = 91 sites) reported providing at least one lactation support: 95% offered educational materials, 89% community referrals, 77% personalized support from a community-based provider, 69% live education sessions, 68% breast pumps, 51% peer support programming, 34% personalized support from a board-certified lactation professional, and 34% lactation-related supplies. Most sites continued to offer lactation supports during the COVID-19 pandemic but faced multiple service provision challenges. Availability of lactation supports that required additional resources beyond CPNP core funds varied by site characteristics. To provide lactation supports, particularly personalized support, most sites reported relying heavily on non-CPNP funds (e.g. donations, private funding).

Lactation support delivery varied widely across CPNP sites, with access differing by site characteristics and external resource availability. Increased programmatic guidance and support of core lactation resources holds potential to ensure consistent lactation support availability and reduce disparities in perinatal health and nutrition.