Improved support key to helping birthing parents with developmental disabilities breastfeed
Breastfeeding has a variety of health benefits for babies and parents, but studies have shown that people with disabilities are less likely to breastfeed, and some have suggested that they face unique challenges or barriers that make breastfeeding more difficult. People with disabilities are also at elevated risk of pregnancy and postpartum complications compared to those without disabilities. Despite this evidence, up until now there were no Canadian studies on this topic.
Dr. Hilary K. Brown and a team including Drs. Cindy-Lee Dennis, Yona Lunsky, and Simone Vigod set out to change this with their study of breastfeeding among people with disabilities in Ontario. The results they found were a mix of encouraging and concerning – and suggest that more could be done to support people with developmental disabilities who are considering breastfeeding.
What are the benefits to breastfeeding?
HB: Breastfeeding has numerous benefits for both children and birthing parents. For children, longer duration of breastfeeding is associated with lower rates of ear infections and respiratory tract infections. It is linked with reduced risk of obesity and type 2 diabetes later in life. It is also associated with better cognitive outcomes. For birthing parents, breastfeeding reduces the risk of future breast and ovarian cancers, as well as cardiovascular disease.
What motivated this research?
HB: Our previous research shows that one in eight birthing people in Ontario has a physical, sensory, or developmental disability. We also previously showed that people with disabilities are at elevated risk of pregnancy and postpartum complications compared to those without disabilities. Studies from other countries that featured interviews with birthing people with disabilities suggest they face unique challenges that make them less likely to breastfeed. However, there are very few studies – and no Canadian studies – looking at breastfeeding outcomes among those with disabilities. Clinical guidelines that support pregnancy and breastfeeding do not typically include any information addressing the needs of people with disabilities. More information is needed to support inclusion of disability in these kinds of guidelines.
What was the most important finding of this study, in your opinion?
HB: We found that people with developmental disabilities are less likely than those without disabilities to breastfeed, have skin-to-skin contact with their baby, or receive breastfeeding supports in hospital. Interestingly, these differences narrowed when we included only people who reported during pregnancy that they intended to breastfeed. This suggests that breastfeeding intentions played an important role in explaining the differences that we observed.
An encouraging finding was that there were few meaningful differences in breastfeeding outcomes for people with physical or sensory disabilities.
How does this change treatment and practices in the future for the disabled?
HB: Our findings suggest the need for more research to understand factors that influence breastfeeding intentions in people with developmental disabilities. They also suggest that more could be done during prenatal care to help people with disabilities to understand the benefits of breastfeeding and to make informed choices about breastfeeding. Alongside these efforts, there is a need for health care providers to receive more training regarding disability, accessible communication, and learning needs, and to develop a greater understanding of the intersection between disability and structural barriers to breastfeeding.
Any next steps?
HB: Our study also interviews birthing people with disabilities about their pregnancy and postpartum care experiences. These interviews showed some interesting results related to a lack of tailored supports for breastfeeding, which we are in the process of publishing.
What is the major take home message for the public?
HB: People with developmental disabilities experienced important disparities in breastfeeding practices and supports during the birth hospital stay that may be addressed through better prenatal education and supports, as well as health care provider education.
ImPACT Committee includes Krista Lanctôt, Alastair Flint, Meng-Chuan Lai and Simone Vigod.
Brown HK, Taylor C, Vigod SN, Dennis CL, Fung K, Chen S, Guttmann A, Havercamp SM, Parish SL, Ray JG, Lunsky Y. Disability and in-hospital breastfeeding practices and supports in Ontario, Canada: a population-based study. Lancet Public Health. 2023 Jan;8(1):e47-e56. doi: 10.1016/S2468-2667(22)00310-3. PMID: 36603911; PMCID: PMC9831273.