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The earliest years of life set the stage for everything that follows. Experiences in the womb and in early childhood can shape health, development, and wellbeing across the entire life course. Prenatal exposures – such as undernutrition, gestational diabetes, or low birth weight – are linked to higher risks of chronic disease, developmental challenges, and even mental health conditions later in life.

For families facing socioeconomic hardship, the challenges are even greater. Limited access to perinatal care, financial stress, and social isolation can compound risks for both mothers and children. Yet, these same families are often the most receptive to support when it is offered – whether through home visits, nutritional programs, or community-based services.

Public health programs that provide targeted support during pregnancy and the first years of life are designed to help close these gaps. One such program in New Brunswick is Healthy Families, Healthy Babies.

What is Healthy Families, Healthy Babies?

Healthy Families, Healthy Babies (HFHB for short) is a provincial public health program that combines universal services – such as newborn screening and toddler assessments – with targeted supports for families at higher risk of poor outcomes.

Targeted services include prenatal and postnatal home visiting for first-time families, where public health nurses and dietitians provide in-home support, breastfeeding guidance, referrals to other programs, and ongoing monitoring of child development. The goal is to foster healthy pregnancies, support parents, and promote healthy child development up to age two.

Evaluating targeted perinatal services

While home visiting programs are widely used across Canada and internationally, their impacts have not been consistently assessed in Canadian populations. In fact, there is a lack of program-specific outcome evaluations for public health initiatives in Canada. This makes it difficult for decision-makers to understand what works, for whom, and under what circumstances.

To help fill this gap, researchers at DataNB and the Maritime SPOR SUPPORT Unit (MSSU) undertook a multi-part evaluation of HFHB. Using linked administrative data and qualitative research, the project examined both the prenatal and postnatal components of the program, as well as broader questions about access to prenatal care and models of integrated maternity services.

The result is a four-part body of work that provides some of the first Canadian-specific, real-world evidence on the impacts of targeted perinatal public health programming.

What we learned: Four reports

1. Postnatal home visiting
   Our first report, released in 2023, looked at the impacts of HFHB’s postnatal home visiting program on breastfeeding and child development. Following more than 6,000 first-time families, the study found that program participants breastfed significantly longer – on average, 33 days more – and were more than twice as likely to still be breastfeeding at 18 months. This suggests that postnatal home visiting supports healthier breastfeeding behaviours, a critical early-life factor, though impacts on child development were not observed in this study.
   
   
2. Prenatal home visiting
   Our second report, released in 2025, focused on the prenatal component of HFHB, examining pregnancy, birth, nutritional, and developmental outcomes among 4,000 first-time families. While broad impacts were not observed, the prenatal program may help reduce certain pregnancy-related risks, such as gestational hypertension, underscoring the importance of continued evaluation.
   
   
3. Lived experiences of disadvantaged mothers
   Numbers tell part of the story, but lived experiences tell another. The third report – published in BMC Pregnancy and Childbirth – used interviews with socioeconomically disadvantaged first-time mothers to explore barriers to prenatal care. Participants described provider shortages, fragmented care, long travel distances, and the importance of trust in provider interactions. Many relied on informal networks and community organizations rather than formal programs, underscoring the need for better outreach, integration, and support for vulnerable families.
   
   
4. Models of integrated maternity care
   The fourth report, written by our partners at MSSU, is a literature review on models of integrated maternity care. It looks at how different jurisdictions have designed systems that connect healthcare and social supports for pregnant people experiencing disadvantage. These integrated approaches highlight ways to improve access, quality, and continuity of maternity services, especially for families facing greater challenges. For New Brunswick, the review offers valuable context as the province considers how best to deliver prenatal and postnatal supports.

Public health program evaluations matter

Together, these four reports provide a rare, Canadian-specific look at the impacts of a provincial perinatal program. They show both the promise and the limitations of targeted supports like HFHB, and they highlight the importance of ongoing, program-specific outcome evaluations.

For families, the findings underscore that early supports can make a difference – whether through longer breastfeeding, reduced pregnancy risks, or stronger community connections. For decision-makers, the research offers evidence to guide future planning and delivery of public health programs.

Most importantly, this project demonstrates the value of evaluating programs in real-world Canadian contexts. By building evidence here at home, we can better understand how to support families during the earliest, most critical years of life.