Nova Scotia Midwives’ Perceived Barriers and Facilitators to Baby-Friendly Initiative Implementation
Bibliographic record
Abstract
Background: Breastfeeding has numerous benefits for both breastfeeding parent and child, yet breastfeeding rates in Nova Scotia are among the lowest in Canada. The Baby-Friendly Initiative (BFI) is a breastfeeding promotion program designed to support the initiation, exclusivity, and duration of breastfeeding. While the BFI can improve breastfeeding outcomes, it is not implemented across Nova Scotia. Methods: We used a qualitative descriptive design, employing semi-structured virtual interviews to understand midwives’ perceptions of barriers and facilitators to BFI implementation in Nova Scotia. Interview data were transcribed and analyzed using inductive-deductive qualitative content analysis guided by the Theoretical Domains Framework (TDF) and COM-B Model of Behaviour. Results: Study participants (n = 2) identified barriers and facilitators related to 1) client education needed to support breastfeeding; 2) family, peer, and community supports needed for breastfeeding; and 3) equity in access to breastfeeding supports. Client education early in the perinatal period was seen as a key facilitator of BFI. Community supports were identified as essential enablers of breastfeeding and the BFI. Participants identified inequities in access to breastfeeding supports that could be addressed by widespread implementation of the midwifery care model. Discussion: Our findings highlight the importance of midwifery care for supporting exclusive breastfeeding and BFI implementation. Continuity of care, consistent access to knowledge and supports, and family-centered social-emotional support throughout the perinatal period are key components of the midwifery care approach that should be adopted across the health system. Findings will be used to inform future research to support BFI implementation and breastfeeding across Nova Scotia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".