A Canadian Perspective of Baby Friendly Initiative
Slide 2
BCC History Est. in 1991 after World Summit for Children 1996
BCC identified as National Authority for WHO/UNICEF Baby Friendly
Hospital Initiative 1999 Canadas first BFI designated hospital
(Brome- Missisquoi-Perkins, Quebec)
Slide 3
2000 BFI Community Committee formed, began BFI for Community
Health Services 2001 BCC P/T Committee established 2003 second BFI
designation St. Josephs Health Care, Ontario
Slide 4
2003 3 BFI Assessor Training workshops 2003 released Practice
Outcome Indicators for hospital & community 2004 Canadas third
BFI designation le centre hospitalier Saint-Eustache, Quebec; first
CHS designation CLSC dArgenteuil, Quebec
2011-32 facilities designated 2012 National symposium and BFI
Assessor training, BFI Practice Outcome Indicators Completed 2013-
BFI integrated in Qmentum Standards for OBS/Perinatal Services for
Accreditation Canada 2014- 3 Assessor Training workshops
Slide 7
Partnerships & Contributions Partnerships with Health
Canada, CPNP, CPS, Canadian Diabetes Assoc. & PHAC Contribution
to WHO international meetings Contribution to: CPS nutrition
committee NHTI birth-6 months & 6-24 months CPNP Practical
Workbook Healthy Weights: Our Health, Our Future Family Centered
Maternal Newborn Guidelines revision
Slide 8
Structure: Membership: Past Chair Chair/ Acting Chair Chair
Elect Treasurer Secretary Members at large BCC Board BCC Provincial
Territorial Implementation Committee BFI Assessment Committee
Slide 9
BFI Designated Facilities in Canada BCSKMBONQCTotal
Hospitals213612 Birthing Centres77 Community/CLSC11692109 Native
Health Center11 Total21119106129
Slide 10
The Baby-Friendly Initiative (BFI) in Canada Status Report
Summary: Provincial and Territorial BFI Activity (2014)
Slide 11
BCABSKMBONQCNBNSPENLNTYKNU P/T Breastfeeding/BFI Policy or
Strategy YNYYY yYYNYNN N P/T BF/BFI Committee/Coalition YYYYY NYYYY
N N N P/T Breastfeeding Education Opportunities YNYYy yYYYY N N N
P/T BFI Survey - Monitoring of BF(I) Implementation YNYYY yYNNYY
Baby-Friendly Designated Facilities 2N111525NNNNNNN Human Milk Bank
11NN 1 1N NNNNN P/T Government Financial Support YYNYy YYYNY * P/T
BFI Coordinator and/or Government Lead YNYYyYYYNY * BCC BFI
Assessor YNNNYYYYNNNNN BCC BFI Assessor Candidate/ apprentice
YYYYYYYYNYNNN *In progress YYes NNo Investigating implementation
opportunities No information
Slide 12
Provincial perspective of BFI
Slide 13
Newfoundland & Labrador Baby-Friendly Council of NL-
designated provincial body for BFI implementation Provincial
Breastfeeding Consultant (0.5 position) Annual provincial
government funding Provincial Breastfeeding Strategic Plan (1999,
2008, 2014)
Slide 14
NL Working Groups- BFI, Communication & Strategy, Research,
Public Education & Awareness Social marketing campaign-posters,
videos, bus ads, Make Breastfeeding Your Business Toolkit Website,
social media (Facebook, Twitter, YouTube)
Slide 15
NL 2013-14 BFI Self-Appraisal in all four RHAs BFI education
>600 hcps completed Making a Difference Breastfeeding Course and
Step 2 Education online 20 hour course Physician Tool Kit resource
Health professional association leadership/advocacy e.g., ARNNL,
NLPHA
Slide 16
NL Strong research agenda Provincial infant feeding study
(FiNaL Study) Qualitative research (e.g., grandmothers) Health
services utilization study BFI compliance study 2012-13 CIHR funded
Caf Scientifque Research symposia BF hospital data for 30 years
(mandatory for public health to collect BF data-90% seen by public
health)
Slide 17
Strategic Plan 2014- 2017 Physician Toolkit > 2100 Facebook
Members Metrobus Ads Poster Campaign www.babyfriendlynl.ca
Baby-Friendly Council of Newfoundland and Labrador New Website!
Research Initiatives Health Professional Education Provincial
Resources Make Breastfeeding Your Business Toolkit Mother-to-
Mother Support Facebook Group Delay the Bath >65,000 views on
Facebook
Slide 18
Prince Edward Island PEI Breastfeeding Coalition hosting a
Provincial Symposium - May 2015 with Janet Murphy Goodridge as
Guest Speaker Baby Friendly Steering Committee established by
Health PEI 2014 to provide: oversight and guidance in the
implementation of the Department of Health and Wellness
Breastfeeding Policy, and the development of an implementation plan
for moving toward Baby Friendly accreditation for Health PEI The
Steering Committee is to develop a Project Charter and Work Plan
for consideration and approval by Executive Leadership.
Slide 19
Nova Scotia Provincial Breastfeeding Steering Committee (est
1999) Provincial Breastfeeding Policy (est 2005, revision 2015)
Thrive! government strategy for healthy public policy 2012
(breastfeeding a key priority) Breastfeeding Grants - over $800,000
Cost effective analysis for increasing access to pasteurized donor
milk Provincial BFI Coordinator (time limited position with
specific objectives)
Slide 20
NS Provincial Formula Purchase Agreement Data collection: pilot
project for community exclusivity and duration
Slide 21
New Brunswick The NB BFI Advisory Committee provincial
authority Support to Health Care Facilities: BFI roundtable, annual
breastfeeding management workshop and series of case studies Mock
assessment and capacity building visits Mentorship model for the
supervised clinical practicum Provincial processes and tools Policy
and Protocols Department of Health Breastfeeding policy statement
BFI / Breastfeeding policy /BFI workplace policy in both Regional
Health Authorities Practice protocols for Health Care
Providers
Slide 22
NB Public Awareness, Education and Breastfeeding Community
Support Promotional and educational materials, Facebook page, video
vignettes Supportive environment for breastfeeding (libraries,
restaurants, municipalities, etc.) Surveillance, Research and
Evaluation Data collection on breastfeeding initiation, exclusive
breastfeeding at hospital discharge BFI self-assessment to monitor
BFI implementation progress in Health Care facilities
Slide 23
Quebec 1997 mandated implementation of BFI Provincial
breastfeeding guidelines 2001 to present Provincial Public Health
Program 2003-2015 mandated the implementation of BFI for hospitals
and community Ministre de la Sant et des Services Sociaux lead
provincial role for BF Responsible for assessment and certification
of BFI in Quebec
Slide 24
QC Quebec has 106 designated facilities 92 CLSCs or community
health centers 7 birthing centers 6 hospitals 1 aboriginal health
center
Slide 25
First Baby Friendly Aboriginal Centre Kanesatake Health Centre
Rural community of 1500 Mohawk people South West of Montreal in
Quebec Peer counselor program- empowering other women to remember
their ancient tradition of breastfeeding their children 1995 32%
initiation rate 2011 90% initiation and duration rates!
Slide 26
Ontario BFI Ontario provincial authority for BFI implementation
in Ontario (over 300 people) Knowledge exchange: Ask and Assessor
and BFI expo Ministry of Health and Long-Term Care Government goal
to reduce childhood obesity by 20% by 2018 2009: Provincial Council
for Maternal and Child Health (PCMCH) led Breastfeeding Supports
expert panel 2011: Implemented the BFI Status performance indicator
for Ontarios 36 Public Health Units 2013: Healthy Kids Panel
report, No Time to Wait: The Healthy Kids Strategy
http://www.health.gov.on.ca/en/common/ministry/publications/reports/healthy_kids/heal
thy_kids.pdf
Slide 27
ON In October 2013, Ontario announced new investments of $2.5
million each year, 2013 to 2016, for enhanced breastfeeding
supports: Providing 24-hour telephone access to expert support for
mothers who are breastfeeding. Supporting Ontario's hospitals and
community health care organizations with training, tools, guidance
and resources and adopt clinical best practices in infant feeding
that meet BFI designation requirements. Targeted support for
mothers in population groups that have lower rates of
breastfeeding.
Slide 28
ON Ontarios Human Milk Bank 2013 Mt Sinai Hospital, Hospital
for Sick Children and Sunny Brook Breastfeeding Matters, a parent-
friendly resource, maintained by Best Start Resource Centre,
updated in 2013 2009: Better Outcomes Registry and Network (BORN)
and recently LDCP supports collection of BF data
Slide 29
Manitoba Baby Friendly Manitoba designated by Manitoba Health,
Healthy Living & Seniors as the provincial authority for
implementing BFI Manitoba Breastfeeding Strategy (2013 & 2006)
75% all birthing facilities and community health sites to be
designated by 2018 BFI hospital and community provincial working
groups with members from all birthing hospitals/regions Baby
Friendly Provincial Consultant 5 BCC BFI Assessor Candidates
Slide 30
MB Annual Baby Friendly Manitoba host conference &
quarterly telehealth research rounds (CERPs provided) SharePoint
site developed for BFI working group members to facilitate shared
resources, tools, educational material, policies
Slide 31
MB Baby Friendly MB Resources (posters, crib cards, magnets,
measuring tapes, Babies Best Chance, infant feeding resources)
Breastfeeding and Baby Friendly information on MB Health website
Bethesda Hospital first in MB designated BFI in 2014, one community
site preparing for External Assessment in 2015
Slide 32
Saskatchewan Breastfeeding Committee for Saskatchewan 1994
Provides support, advice, creation of networks, sharing
information, resources & develops strategic plan with a yearly
action plan. Provincial early childhood assessment services support
BFI Provincial handouts for child health clinics support BFI
Saskatchewan has one CHS designated BFI
Slide 33
Alberta Alberta Breastfeeding Committee Leadership and
resources Assisting BFI process in Alberta Hosting 2015 Symposium!
Ministry representation on ABC and BCC PT Committee Community based
Human Milk Bank Provincial Surveillance in process Covenant
Health
Slide 34
Alberta Alberta Health Services (AHS) Provincial STORC
Breastfeeding Module Working Group AHS 2013 provincial
environmental scan AHS online breastfeeding module for healthcare
providers AHS Healthy Parents, Healthy Children print and online
resources
Slide 35
British Columbia BC Baby Friendly Network designated by
Ministry of Health and Ministry of Children and Family Development
as the implementation committee for the BFI Healthy Families BC:
Healthy Start Initiative. Healthy Families BC Parent Resources
updated breastfeeding content in Babys Best Chance and online at
www.healthyfamiliesbc.ca Translation of key online content in 3
languages.www.healthyfamiliesbc.ca Healthy families BC Social
Media.
Slide 36
BC HealthLink BC - breastfeeding lab established to build
capacity of 24/7 telehealth nurses to manage breastfeeding
enquiries. Provincial Formula contract signed by all health
authorities.
Slide 37
BC Hosted a Making a Difference train the trainer course.
Provincial Breastfeeding Think Tank held on March 23 rd to inform a
Provincial Breastfeeding Plan and the implementation of BFI in
BC.
Slide 38
BC BF monitoring & Surveillance Breastfeeding Trends in BC
Fact Sheet published and available on the
www.perinatalservicesbc.ca website. Exclusive BF rates from birth
to discharge are one of the Facility-Level indicators that are
reported and available to the public. Establishing minimal
breastfeeding data standards for provincial public health
information systems. www.perinatalservicesbc.ca
Slide 39
BC Expansion of BCW Human Milk Bank. Milk depots implemented in
one health authority with plans for implementation of depots in
other HAs. Peer to Peer milk sharing HCP resource being developed.
Proposal submitted to provincial steering committee for a
Provincial BFI coordinator.
Slide 40
Yukon Yukon Governments Community Nursing Branch is committed
to providing BF education to all nursing staff. No BFI group and no
provincial/territorial strategies for BFI implementation
Slide 41
Nunavut Department of Health & Social Services lead role
for BF services FNIHB -CPNP and mat/child health programs
Participate on BCC P/T implementation committee No Territorial BF
committee established Nutrition Framework and Public Health
Strategy specify BF is a priority Maternal and Child Health
Surveillance System, collecting data at birth, 6 months & 1
year Source:
http://www.canadian-nurse.com/en/articles/issues/2009/june-2009/nursing-in-nunavut
Slide 42
Northwest Territory Ministry, CPNP, health services, aboriginal
health and mother support are working with BFI Assessment Committee
to build awareness capacity Member of BCC PT Committee Capacity
building workshop held BFI Certificate of Participation signed by
Minister of Health and Social Services
Slide 43
Infant Feeding Surveillance The British Columbia Pan-Canadian
Breastfeeding Jurisdictional Scan Most collect data on initiation
and hospital discharge Duration and exclusivity data collected
primarily by PHS (incomplete) Follow up surveys snap shots of time
Nunavut surveillance system Manitoba provincial data linked to CCHS
Saskatchewan data collection system NL monitoring data, mandatory
for Public Health NB initiation, exclusivity and discharge NS
initiation, exclusivity and duration (pilot) Ontario BORN and
LDCP
Slide 44
Infant Feeding Surveillance BCC definitions CCHS data (caution
with small sample size and recall bias) Maternity Experiences
Survey No national infant feeding surveillance system
Slide 45
BCC future directions: P/T Implementation Committee lead in BFI
journey toward designation Assessment Committee arms length support
to facilities, building capacity of PT members Focused attention
for hospital facilities BCC sustainability (financial and
governance)
Slide 46
Need for a national BFI Strategy Code compliance and national
formula contracts, Robust national BF surveillance system
International accountability