Indicator Rationale
Prevalence of breastfeeding is a measure linked to prevention of health problems in children. Breastfeeding provides the essential nutrients for healthy growth and aids in resistance to infection and the prevention of allergies. Breastfeeding also facilitates bonding between mother and child. Research indicates that children should be breastfed a minimum of 6 months or more for optimal health of the baby. However, mothers may discontinue breastfeeding their children for a number of reasons including a lack of knowledge, difficulty breastfeeding, and unsupported environments for breastfeeding.
Data Source
Data are compiled on a financial year basis from information submitted by individual Maternal and Child Health (M&CH) Centres. Data should be checked and, if necessary, corrected at this stage. The information is then aggregated to form data at the Local Government Area (LGA) level. Once compiled at LGA level and submitted, data are not further corrected.
The data have been sourced directly from the Breastfeeding Rates table in the Maternal & Child Health Services Annual Report.
In most cases, M&CH services are provided by local councils. Each provider maintains a client management system that records basic client information and information relating to clients’ (children and parents) usage of the service. The client management system provides the principal record through which M&CH Nurses record activities undertaken with clients and client-based notes. The client management system is also the principal system through which information is sourced for compilation into the Maternal & Child Health Services Annual Report. Across Victoria, a range of different client management systems are used – manual paper-based systems; in house (i.e. self developed) software systems; and commercial software systems. As at March 2006, one system (the Maternal and Child Health System (MaCHS) program) was used by 55 of the 79 Victorian municipalities, however smaller non-metropolitan councils were less likely than larger metropolitan councils to be using this system. Whichever system is used, it is highly reliant on M&CH Nurses completing the relevant data entry, and there may be limited processes in place for updating, reviewing and enhancing the quality and reliability of the data. (KPMG (2006)).
Measure
Children Fully Breastfed at 6 Months of Age: expressed as a percentage of M&CH enrolled children born in the previous financial year.
Births in a financial year relate to the date of receipt by the M&CH Centre of the birth notification, rather than the actual date of birth.
The total count of children fully breastfed is based on a collation of data from enrolment records for each M&CH Centre of children born in the previous financial year, which is the latest complete set of data. Children born in the second half of the current financial year (the financial year to which the majority of data in the Maternal & Child Health Services Annual Report relate) have not yet turned 6-months-old, and so a complete measure of breastfeeding status at that age cannot yet be derived.
Breastfeeding rates can vary significantly between LGAs. This could be due to a number of factors including: municipalities running different programs, or having nurses with a different client support approach to increase breast feeding rates; and socio-economic factors which may have secondary lifestyle impacts (e.g. in some areas, a higher proportion of mothers may be required to return to work sooner than in other areas) which affect breastfeeding rates. (KPMG (2006)).
The total count of enrolments in a particular financial year for each age cohort is based on an aggregation of the number of record cards for that age cohort. For the first age cohort, this will be enrolments from birth notifications received in the current financial year and any other new enrolments (e.g. transfers in) over the course of the financial year. Transfers out over the financial year will be subtracted. For subsequent age cohorts, the number of enrolments will be that from the previous financial year, but adjusted to account for new enrolments or transfers out over the current year.
When compared with ABS Estimated Resident Population (ERP), M&CH enrolments may be overstated. At 30 June 2006, the number of M&CH enrolments of children aged 0-4 years (i.e. yet to turn 5-years-old) across Victoria was 2.4% higher than the corresponding ERP figure. This may have the effect of the reported data slightly understating the true participation rate in M&CH. Family mobility may be a source of potential overstatement if enrolment details are not updated when a family moves. Children may remain enrolled with a particular M&CH service even though the family have moved out of the area. This could be the case if a family moves interstate or overseas, or moves within Victoria but the family is no longer actively attending the M&CH service. With more than one client management system in place, family moves also create the potential for duplicate records to be created as a result. If a M&CH provider is using the MaCHS system, a state-wide unique child identifier is created when the birth is notified, and this unique identifier follows the child if the parents move (KPMG (2006)). However, if a child moves out of or into the MaCHS system 'area' this will not be the case.
References
KPMG, Evaluation of Victorian Maternal and Child Health Service, 2006
Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ, et al, Breastfeeding and the use of human milk. American Academy of Pediatrics. Section on Breastfeeding. Pediatrics 2005; 115(2): 496-506.
Fewtrell MS. The long-term benefits of having been breast-fed. Current Paediatrics 2004; 14 (2): 97-103.
