In Community Health Services (BFI in CHS)Teleconference

Thursday, October 9, 2014 - 10:00 a.m. to 12:00 p.m.MINUTES

Date: October 9, 2014Time: 10:00am – 12:00p.m.

Chair: Grace Machado (Peel)Recorder: Jennifer Beck (Hamilton)

Present:

Name Health Unit/CentreBarb Bartle BrantJill Mather TorontoWendy Lahey Wellington-Dufferin-GuelphJennifer McCuaig Renfrew County & DistrictNancy McGeachy Hastings & Prince Edward CountyJennifer Wyscaver Elgin-St. ThomasLucy Bray Simcoe/MuskokaMirana Silta Thunder BayCatherine Lowes NiagaraTammy Thomson HKPRKim Lichty Two Rivers Family Health Team – CambridgeAnn Ciniglio York RegionEvelyn te Nyenhuis York RegionSue Gierszewski HaltonAnna West HaltonMarguerite Falconer Huron CountyJennifer Beck HamiltonMelinda Bruno AlgomaCindy Johnston PeelTania O’Connor OttawaGlenda Blair PerthHeather Kane PerthNicole Ethier PorcupineNancy Chiasson PorcupineAmber Newport Durham RegionDebbie Godfrey Durham RegionJoan Bordash Durham RegionSarah Sharrard Durham Region

Item # Discussion Action

1.0 Welcome

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2.0 Review of Minutes from June 12, 2014

Item 3.6 – Action item: Jill will not attach mock questions to minutes (change)

Item 3.1 - Action item: Re: proposal to change World Breastfeeding Week to August; provide feedback to Anne Mixed reactions thus far BFI was amending letter and re-sending At Halton BFI meeting – discussion re: keeping both August

and October WBW’s, but possibly lobby for October WBW to be called Canadian WBW

Item 3.2 - BF Supports Website – bilingual – Dawn was to compile questions and send to Hiltrud. Most problems have been addressed. Hiltrud still open to receiving feedback.

Item 4.1 - Breastfeeding during painful procedures – Tania from Ottawa from Ottawa was to look for background research that their VPD department used regarding this. Info was sent Catharine (Niagara).

Item 4.1 - Immunization app – Catharine Lowes (Niagara), to touch base with Anne Smith to discuss how BFI Ontario is dealing with this issue.

Item 4.2 – New Video Resource re: intro to solids from York, Toronto & Peel - in editing phase. Rough cut completed. Unsure re: completion date.

Anne Smith not present at teleconference today. Will provide update at next meeting.

Email Hiltrud with any further concerns.

Catharine will email Grace today re: update for dissemination to members.

Update will provided at next meeting.

2.1 Approval of Minutes from June 12, 2014

Minutes approved by Heather Kane (North Bay).

3.0 New Business

3.1 HBHC/BFI – Guest: Bernadette Candeloro Guest: Bernadette Candeloro (Program Consultant, Child and

Youth Development Branch, Ministry of Children and Youth Services)

Joint communication came out Wednesday, October 8, 2014 from directors of both the Ministry of Children and Youth Services and the director of the Ministry of Health and Long Term Care, as well as BFI Ontario representative Anne Smith. Sent to managers and directors of Family Health. Letter is to address issues re: incongruences b/w NCAST, PIPE and BFI.

Letter outlined three key considerations:1. NCAST/PIPE should only be delivered in the manner

that they were intended. Meant for high risk

Ensure letter is filtered down to front line staff in each health unit.

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population and to be used on a 1:1 basis when it is appropriate to use. Used only after IDA completed, risk has been determined and after feeding decision has been made.

2. Health Units are encouraged to use PIPE/NCAST to guide practice. PHN’s are to use critical thinking and professional judgement disseminating and using particular materials with clients.

3. HU are encouraged to consult with BFI Ontario if issuesarise re: use of these materials.

Attached to document – 2 appendices:a. BFI Ontario outline – synopsis of BFI concerns with

Curriculums b. MCYS – guidelines for use of NCAST and PIPE materials.

Targeted application to meet needs of high risk families. Any time any material is used the principles and materials of BFI need to be considered.

Both PIPE and NCAST are evidenced-based and meant to assist in standardizing messaging for HBHC program. Not at liberty to change materials, but can discuss how they are used in practice. Have asked that certain pieces not be used.

Anne – York – ? re: copyright and copying handouts. Berni made group aware that we have permission to “adapt” certain things (ie. copy a handout without a picture, crossing pacifier out.) Any/all permissions outlined in letter.

Both PIPE/NCAST are willing to change a lot of their material based on feedback re: BFI. NCAST is re-writing feeding manual and requesting Canadian content. Changes will take time. They are listening and taking concerns seriously.

Other updates: Keys to Caregiving: Foundations to Maternal Mental Health

- have been concerns re: these and BFI Currently, finishing up some revisions on materials that

will be used as a refresher for staff and as initial training for new staff.

Powerpoints will be developed with voice over. Voice over will allow for BFI concerns to be addressed during these modules, without having to change copyrighted material. Calling issues to forefront. Hope to have presentations ready by end of year or beginning of next year. This is another attempt to deliver standardized messaging on behalf of both the BFI and NCAST/PIPE.

If have questions from letter, contacts are listed in letter.

3.2 Homemade Formula Evelyn (York) - Came into to contact with two families that are

using homemade infant formula. There is a naturopath - Dr. Laura Margaritas based out of

Hamilton - giving inservices re: using homemade formula.

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Representative from Peel went to inservice. Naturopath encouraging raw egg yolk in bottle at 4 mos. old. Not sure how prevalent this is.

Evelyn spoke with dietitians in her Health Unit. Dietitians plan to bring this to working group OSNPPH (Ontario Society of Nutrition Professionals in Public Heatlh).

Need to think about the way we ask questions re: infant feeding. Nutrition team putting together chart for families either considering or using homemade infant formula.

3.3 New Video Grace from Peel updated group re: new video as many people

access Peel’s BF videos on their website and get many requests for linking to BF videos in Peel.

Received funding to look at an area to increase the rates within a particular population. Looked at their BF rates and how to support them. New interventions implemented to support mothers who have had a c-section to successfully breastfeed:

1. New prenatal class for moms having c/s and planning to BF - going to try and weave peer support into this as well

2. Enhancement of HBHC HV’s - BF team will be able to do more visits for these families.

3. New video also be developed. Will be posted on Peel’s website.

Grace to see how some of the handouts can be shared with other health units.

3.4 Breastfeeding Campaigns Jill (Toronto) – updated group re: breastfeeding in public

campaign launched Oct. 1st Adaptation from Algoma PH. Used lifesize cutouts of

breastfeeding women in various locations around Torontolast week. Created video with professional actors and sometestimonials. Had contest through SM. Campaign very wellreceived.

If want to take a look at components of it can visit website: www1.toronto.ca/breastfeeding. Getting lots of positive feedback and getting requests to use cutouts again. This will be part of evaluation process.

Niagara ran same campaign at same time. Cutouts were young moms under 21. Running for one month. Has gone viral through social media. Had ++ likes and shares and discussed on a blog in the US. Picked up by Kellymom and breastfeeding mama talk. There is a survey on breastfeedingniagara.ca. Campaign not run through HU, but coalition.• http://www.breastfeedingniagara.ca/community-breastfeeding-in-public.html See photos at end of minutes

Durham working on doing a similar campaign as well. Algoma has kept running their campaign over last year. HKPR – requesting HUs share their end results re: their

Jill to share evaluation of campaign once completed.

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campaigns. Hamilton – update re: campaign – focusing on increasing

exclusive breastfeeding rates to six months and importance of support. Developed two messages and videos. Will provide more information at next meeting.

3.5 WBW Celebrations Nancy (Hastings) provided update re: breastfeeding celebration

last week. Purchased documentary called the “Milky Way” to show at theatre. 220 people came out and reviewed the movie. Partnered with local college and Dean agreed to allow the

nursing students come to movie, then had to do a review paper on it. 80 students attended. Helped students understand the effect of their support on breastfeeding women. Will look how they can continue to do this.

There was incident at Tim Horton’s in Tweed where breastfeeding mother was approached by supervisor and asked to cover up. Contacted Tim Hortons corporate as well as local Tim

Hortons’ in area with proposal suggesting they consider implementing their breastfeeding friendly workplace guidelines. Tim Horton’s corporate taking forward to their HR department.

Proposal to be shared with Ann Ciniglio (York)

3.6 New Handouts from York Region Ann (York) – provided update re: reproduction of handouts

from York Region. Have been getting several requests for reproduction. If want to use them, email Ann and she will send form that will need to be filled out. Also need to send photo consent from requesting health unit to Ann. Have no issue with agreeing to reproduce content, but pictures are a bit more challenging New handouts include:

1. Breastmilk in childcare settings2. Supplementation handout3. BF and birth control.

3.7 Upholding the Code Sue (Halton) – HU currently purchasing car seats from Toys R

Us, but concerned that company advertising formula on their website (WHO Code Violation??)

Local store willing to work with them re: product placement and providing information re: breastfeeding.

Manager trying to connect with Kathy Venter regarding this issue. Any responses will be forwarded to group.

This was discussed at a previous teleconference. Nestle Foodbank partnership – to learn more visit

http://infactcanada.ca/food-banks-canada-nestle-letter.html Sample letter on INFACT website if you wish to send one

• York – having final assessment next week – will ask assessors during this time and feedback any information about this.

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3.8 Electronic Record Keeping Cathy (Niagara) – inquiring as to whether or not other health

units use electronic record keeping for breastfeeding assessments

York Region working to have all charting electronic, including BF assessments – creating own database using Infopass – will have more information in about a month

Toronto fully electronic – but had own database created.

This item to be added to next meeting agenda for further discussion

4.0 Next Meeting Date: February 12, 2015 Host: Sponsor of teleconference line: Dial:

1-800-920-7487/Participants’ code: 91388473# Minutes: York Region Back Up Minutes: Jill Mather (Toronto)

Future 2015 Meeting Dates: June 11, 2015 October 8, 2015

Terms of Reference to reviewed at next meeting.

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