Prepared by Brenda Scott, RN, IBCLC
January 2013
 “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

WHO International Code XX
or breast milk substitutes
Elimination of free breast milk
subustitutes i.e. formula

Innocenti Declaration on
protection, promotion and
support of breastfeeding
A statement commital the
WHO/UNICEF to protect, support
and promotion of breastfeeding

Baby Friendly Hospital
Initiative
An initiative encouraging
maternity care providers to
implement breastfeeding locally
and nationally

The Severn Point Plan for the
protection, promotion and
support of breastfeeding
Developed by the UK BFI
Committeee to encourage
breastfeeding implementation
among healthcare professionals
 Is
a global evidenced-based standard of care
 Is a campaign of the WHO/Unicef statement
1991 (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
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
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.
 EVERY
FACILITY PROVIDING MATERNITY
SERVICES AND CARE FOR NEWBORN INFANTS
SHOULD FOLLOW THESE TEN STEPS TO
SUCCESSFUL BREASTFEEDING
 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
 36
Designated Facilities (8 Hospitals, 25
Community Centres Health Services, 3
Birthing Centres)
 Quebec 24
 Ontario 10
 BC 2
 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
 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
 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
 Warmer/calmer
emotional environment
 Fewer neonatal infections
 Less staff time required
 Improved hospital image and prestige
 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
1.
2.
3.
4.
5.
6.
7.
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).
 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 reestablished 2012 with Community partners ie
PHUnit, Midwives
 Goal: GBHS Becomes BFI in 2013
 Breastfeeding
committee for Canada(BCC)
2004. 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
 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)
 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)
 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