The Baby Friendly Initiative in Health Services

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The Baby Friendly Initiative in Health Services
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Health Canada Recommendation

• Exclusive breastfeeding for the first six months
  of life for healthy term infant, as breast milk
  is the best food for optimal growth.
• Infants should be introduced to nutrient rich
  solid foods with particular attention to iron at
  six months with continued breastfeeding for up to
  two years and beyond.

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What Is It?

• A ten step plan that summarizes the maternity
  practices necessary to support breastfeeding.
• The implementation of RNAO best practices that
  protect, support and promote breastfeeding.
• Endorsement of the WHO/UNICEF International
  Code of Marketing of Breast-milk Substitutes.

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1. Have a written breastfeeding policy that is
routinely communicated to all staff and
volunteers.
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2. Train all health care providers in the
knowledge and skills necessary to implement the
breastfeeding policy.
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3. Inform all pregnant women about the benefits
and management of breastfeeding.
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• Help mothers initiate breastfeeding
• within a half-hour of birth.

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5. Show mothers how to breastfeed and how to
maintain lactation even if they should be
separated from their infants.
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6. Give newborn infants no food or drink other
than breastmilk unless medically indicated.
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• Practice rooming-in
• ? Allow mothers and infants to remain together 24
  hours a day.

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8. Encourage breastfeeding on demand.
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9. Give no artificial teats or pacifiers to
breastfeeding infants.
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10. Foster the establishment of breastfeeding
support groups and refer mothers to them on
discharge from the hospital or clinic.
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Compliance with The International Code of
Marketing of Breast-Milk Substitutes.
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The World Health Organization Code for the
Marketing of Breastmilk Substitutes

• Aim To contribute to the provision of safe and
  adequate nutrition for all infants.
• Scope All breast-milk
  substitutes, bottles and nipples and any
  information concerning their use.
• Advertising no advertising of the above products
  to the public.

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The World Health Organization Code for the
Marketing of Breastmilk Substitutes

• Labels Breastmilk substitute labels must
  clearly state the superiority of breastfeeding
  with proper instructions and no pictures of
  infants.
• Samples No free samples to mothers, their
  families or health care workers.
• Facilities No promotion of products covered
  under the scope (displays, posters, pamphlets
  etc.).

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The World Health Organization Code for the
Marketing of Breastmilk Substitutes

• Health Care Workers Accept no gifts or samples.
• Supplies No free or low-cost supplies of breast
  milk substitutes to hospitals.
• Information Educational materials must explain
  the benefits of breastfeeding and the costs
  associated with formula feeding.

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In February 2010 Chatham-Kent Public Health Unit
achieved Baby Friendly Accreditation!

• Where Do We Go From Here?
• Continue to monitor breastfeeding rates at
  hospital discharge, 48 hours post-discharge, and
  2 weeks
• Work to increase exclusive breastfeeding rates to
  6 months and develop a method to obtain data
• Send in yearly reports to the Breastfeeding
  Committee for Canada
• Continue to work with local agencies to increase
  breastfeeding awareness, support and practices
• Re-assessment in 2015

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Who Benefits From Baby Friendly?
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The woman and her child

• Consistent care information
• Skilled help
• Getting off to a good start
• Breastfeeding is valued
• Mothers are empowered

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Caregivers for Mothers and Babies

• Increased knowledge
• Increased skills
• Professional competence
• Respect for women

Care becomes woman-centred not task-centred
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Health Care Facilities

• High Standards of care are measured and met
• Meets the RNAO Best Practice Standards for care
  of breastfeeding mothers and babies

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The Family

• Health and development of the infant
• Health of the mother
• Saves money

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The Community

• Environmentally Friendly
• Social programs
• Decreased costs for medical care

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BREAST IS BEST
FOR BABY
FOR MOTHER
FOR CHATHAM-KENT
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Breastfeeding Is Normal

• Its done worldwide
• Initiation rate 84 at CKHA
• Exclusive breastfeeding at discharge is 40-50
• Breastfeeding rates are dropping dramatically
  until only about 9 are exclusively breastfeeding
  to 6 months

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Attitudes About Breastfeeding

• Attitude affects Behaviour
• Important to explore
• Feelings about breastfeeding
• Myths about Breastfeeding

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When Breastfeeding is Normal, Babies Are Protected

• Venezuelan President Hugo Chavez talks with
  people affected by flooding in Araira, 50 km (31
  miles) from Caracas this past February.

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Why Should Mothers Breastfeed?
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Baby

• Nutritional qualities
• Anti-infective qualities
• Physical qualities
• Psychological qualities

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Nutritional Qualities

• Nutritionally complete for the first 6 months of
  life
• Ensures adequate infant growth

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Anti-infective Qualities

• Provides anti-bodies
• Enhances babys immune system
• Protection from
• Gastrointestinal illnesses
• Respiratory infections
• Ear infections
• Some childhood cancers

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Physical Qualities

• Improved visual development
• Higher IQ
• Protection from
• Diabetes
• Obesity
• SIDS
• Easier to digest

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Psychological Qualities

• Strong maternal/infant bonding
• Greater chance of child developing a secure
  attachment to mother
• Babys needs can be met quickly (builds trust)

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Mother

• Physical qualities
• Psychological qualities

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Physical Qualities

• Protection from
• Pre-menopausal Breast and Ovarian cancer
• Hemorrhage
• Osteoporosis
• Helps weight loss

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Psychological Qualities

• Empowering
• Food for baby always available
• Low cost
• Mothering Hormones

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Anatomy of the Breast

• Changes during pregnancy
• How milk is made

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Changes During Pregnancy

• Breast grow larger
• Skin on breasts appears thinner and veins can be
  seen
• Areola gets larger and darker
• Montgomery tubercles get larger

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Changes During Pregnancy

• Hormones cause breast tissue to grow.
• More Milk Alveoli
• More milk Ducts
• Occurs with each pregnancy

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How Milk Is NOT Made!!!
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Anatomy
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Breast Anatomy

• Babys mouth covers 1/2 - 1 inch of areola

• Montgomery Tubercles

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The Action of Breastfeeding
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The Action of Bottle Feeding
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How Milk Is Made
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Community Resources

• Public Health
• Lactation Consultants
• Baby Weigh In
• As Parent And Baby Grow
• Mother Nurture

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References

• Riordan Auerbach Breastfeeding and Human
  Lactation
• The Breastfeeding Atlas - lactpress ?2002
• Health canada 2002
• Www.Breastfeedingniagara.Com
• Breastfeeding Committee for Canada
• Http//www.Breastfeedingbasics.Org/cgi-bin/deliver
  .Cgi/content/anatomy/str_internal.html
• La Leche League Canada
• http//www.brianpalmerdds.com/pdf/Otitis_media.pdf
  . Palmer, B. (2001). Otitis Media An anatomical
  perspective
• http//www.breastfeeding.com/helpme/helpme_images_
  anatomy.html
• Best Start