1. Baby Friendly Initiative Grey Bruce Health Services
Prepared by Brenda Scott, RN, IBCLC
January 2013

2. Breastfeeding
“Extensive research using improved epidemiologic methods and modern lab techniques documents diverse and compelling advantages for Infants, Mothers, Families and Society”
Policy statement 2005 Pediatrics
Reaffirmed 2009 Joint statement Health Canada, Canadian Paed Society, Dietitians of Canada, Breastfeeding Committee of Canada

3. International Codes, Initiatives & What WHO does.
WHO International Code XX
or breast milk substitutes
Innocenti Declaration on protection, promotion and support of breastfeeding
Baby Friendly Hospital
Initiative
The Severn Point Plan for the protection, promotion and support of breastfeeding
Elimination of free breast milk subustitutes i.e. formula A statement commital the WHO/UNICEF to protect, support and promotion of breastfeeding An initiative encouraging maternity care providers to implement breastfeeding locally and nationally Developed by the UK BFI Committeee to encourage breastfeeding implementation among healthcare professionals

4. Baby Friendly Hospital Initiative
Is a global evidenced-based standard of care
Is a campaign of the WHO/Unicef statement (shown to increase Breastfeeding rates )
Recognizes that implementing Best practice in Hospital is Critical for support and promotion of EXCULSIVE, LONG-TERM Breastfeeding
Best Practice is represented by “The 10 Steps to Successful Breastfeeding” (est. 1989)
1991 Health Canada created the Breastfeeding Committee for Canada

5. Ten Steps to Successful Breastfeeding (Joint WHO/UNICEF Statement, 1989)
Have a written breastfeeding policy that is routinely communicated to all health care staff.
Train all health care staff in skills necessary to implement this policy.
Inform all pregnant women about the benefits and management of breastfeeding.
Help mothers initiate breastfeeding within a half-hour of birth.
Show mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
Give newborn infants no food or drink other than breastmilk unless medically indicated.
Practice rooming-in –allow mothers and infants to remain together -24 hours a day.
Encourage breastfeeding of demand.
Give no artificial teats or pacifiers (soothers, dummies) to breastfeeding infants.
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

6. The Ten Steps to Successful Breastfeeding
EVERY FACILITY PROVIDING MATERNITY SERVICES AND CARE FOR NEWBORN INFANTS SHOULD FOLLOW THESE TEN STEPS TO SUCCESSFUL BREASTFEEDING

7. Breastfeeding Rates Ontario (2008) Initiation rate 88%
At 6 months 16-26%
Breastfeeding Initiation Rate GBHS (2011):
Exclusive Breastfeeding Rate upon Discharge:
Supplementation Rate while Breastfeeding at Discharge:
PHU Breastfeeding rates:
2 wks
6wks

8. Status of Baby-Friendly Hospitals In Canada 2012
36 Designated Facilities (8 Hospitals, 25 Community Centres Health Services, 3 Birthing Centres)
Quebec 24
Ontario 10
BC 2

9. Ministry of Health & Long Term Care - 2009
Requested Provincial Council for Maternal & Child Health est. an “Expert Panel” to support the delivery of Breastfeeding Services in Ontario
RECOMMENDATION- to work toward Implementation of BFI (Breastfeeding Friendly Initiatives)
for healthcare providers, administrators, volunteers in hospital regarding policies/practices NEEDED to promote, support breastfeeding

10. Accreditation Canada EFFECTIVE January 2012
Is referencing BFI practices in its Obstetrical Standards for hospitals, that aligns with the BFI and International Code of Marketing of Breastmilk Substitutes

11. The Baby Friendly Initiative (BFI)
Contributes to Health and development of mother/infant
Excellence in family-centred maternity care
Quality assurance by meeting international standards
Monetary savings for Maternity Units
Increased morale and satisfaction of staff/families
Increased awareness and support of Breastfeeding within the community

12. BENEFITS of BFI to Hospital
Warmer/calmer emotional environment
Fewer neonatal infections
Less staff time required
Improved hospital image and prestige

13. How Can You Help
Support, Promote and Protect Breastfeeding by following the Ten Steps to Successful Breastfeeding
Adhere to international guidelines outlined in the International Code of Marketing of Breastmilk Substitutes

14. International Code of Marketing of Breastmilk Substitutes
No advertising of products (ie formula) to the public.
No FREE Formula samples for mothers.
No promotion of products in Health Care facilities, INCLUDING FREE FORMULA.
No GIFTS or personal samples to Health Care Workers ie free lunches, pens.
No words or pictures idealizing artificial .feeding, including pictures of infants on products.
All information on formula including labels should explain the benefits of Breastfeeding & costs/risks of formula feeding.
(Brief summary of the Code).

15. On the Road to BFI at the GBHS
Review and update existing Hospital Breastfeeding Policy to include BFI goals as per the 10 steps to Successful Breastfeeding
BFI Self Assessment – improvements identified
GBHS BFI Breastfeeding Committee re- established 2012 with Community partners ie PHUnit, Midwives
Goal: GBHS Becomes BFI in 2013

18. References
Breastfeeding committee for Canada(BCC) The Ten Steps and Practice Outcome Indicators for Baby-Friendly Hospitals and The Seven Point Plan for the Protection, Promotion and Support of Breastfeeding in community Health Services.
Canadian Pediatric Society 9Feb 2008) Nutrition for Healthy term infants.
College of Family Physicians of Canada. (2004) Infant Feeding Policy Statement

19. References 2
Dietitians of Canada, Canadian Paediatric Society, The College of Family Physicians of Canada & Community Health nurses of Canada (2010)
Health Canada (2000) Family-Centered Maternity and Newborn Care: National Guidelines, Ottawa
Ministry of Health and Long Term Care (2008)

20. References 3
Registered Nurses Association of Ontario (2007) Breastfeeding Best Practice Guidelines for Nurses.
Society of Obstetricians and Gynaecologists of Canada, Association of Women’s Health, Obstetric and Neonatal Nurses of Canada, Canadian Association of Midwives, College of Family Physicians of Canada & Society of Rural Physicians of Canada (2008)

21. References 4
UNICEF & World Health Organization (2009) Baby-Friendly Hospital Initiative
Joint WHO/Unicef Geneva, 1979
World Health Organization. International Code of Marketing of Breast-milk Substitutes
Protecting, Promoting and Supporting Breastfeeding. A Joint WHO/Unicef Statement, Geneva, WHO, 1989