While Quebec has made significant progress since the launch of the breastfeeding policy L’allaitement maternel au Québec – Lignes directrices [Breastfeeding in Quebec – Policy Guidelines] in 2001, marked regional disparities have been documented in terms of breastfeeding practice and the policy’s implementation. A process evaluation was conducted to assess the development of the Lignes Directrices policy and the factors that facilitated or impeded the implementation of its strategies, in particular the Baby-Friendly Initiative (BFI). For the purpose of the study, interviews were carried out with 214 decision-makers, administrators, perinatal care providers and mothers.
The results highlight the importance of developing a collective action plan involving the various stakeholders affected by the policy, and of including mothers in the decision-making process for breastfeeding-related issues in Quebec.
The project also confirmed the positive impact of the BFI on mothers’ breastfeeding experiences and identified five factors that act as barriers or facilitators to the policy’s implementation in Quebec health institutions, as follows: 1) population-based culture; 2) organizational factors; 3) resources and training of professionals; 4) leadership; and 5) continuity and integration of care and services.
The interviews also led to the observation that encouraging breastfeeding without ensuring access to adequate support during the postnatal period is extremely likely to lead to failure, and to feelings of maternal incompetence on the part of the mother. This project provides many possible courses of action to help guide decision-makers and breastfeeding stakeholders in the implementation of the policy under study and in strategic planning for future breastfeeding policy.
Sonia Semenic, McGill University
Deposit of the research report: April 2012