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Infant Feeding Surveillance (IFS)

Infant Feeding Surveillance (IFS)

The SMDHU Infant Feeding Surveillance (IFS) is a routine survey of Simcoe Muskoka residents with infants who are six to 12 months old. The survey collects data on infant feeding initiation and duration, maternal age, parity, income, education, marital status, immigration, gestational age, birth weight, and birth type. Participants are selected at random from a list of new parents who provided consent to a Healthy Babies Healthy Children screen being completed and sent to the health unit.


Simcoe Muskoka District Health Unit

Data Notes:

  • There is no Ontario comparison for this source.
  • BORN captures infant feeding intention and initiation, but not duration.SMDHU IFS captures infant feeding initiation and duration so both BORN and the SMDHU IFS capture initiation data. This allows for initiation and duration to be measured from the same sample surveyed to ensure consistency of results.
  • The “any” breast milk initiation rate is very similar between the two data sources.  However, the two sources differ in the exclusive breast milk initiation rate and those who were combination feeding (breast milk and a substitute).  BORN exclusive initiation rates are approximately 10% higher than SMDHU IFS, and the complementary combination feeding rates are 10% lower.

    Possible explanations for this difference include:

    • recall bias of SMDHU IFS respondents who may not accurately remember what baby was fed from birth to discharge;
    • sampling bias in SMDHU IFS because the sampling frame is all of those who have consented to have a completed HBHC screen received by the health unit so those people may be systematically different than those who do not have a completed screen;
    • misinterpretation of the BORN definition of ‘initiation’: those who enter data may be capturing infant feeding practice at the time of discharge instead of capturing all types of feeding that occurred from birth to discharge. If baby is supplemented with a breast milk substitute and then returns to only breast milk, this should be captured under combination feeding in BORN, and not exclusive breast milk. SMDHU IFS captures those who have supplemented with a breast milk substitute at one point before two months but ‘returned to only breast milk’ but BORN does not. The sum of the SMDHU IFS‘ returned to only breast milk’ initiation rate of 7.0% and the exclusive initiation rate of 58.1%, is close to the BORN exclusive initiation rate of 68.3%. (Data are from SMDHU IFS 2018).

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