Update on Baby-Friendly Initiative Designation

Report to/Rapport au :
Ottawa Board of Health
Conseil de santé d’Ottawa
Monday, January 21, 2013/ le lundi 21 janvier 2013
Submitted by/Soumis par :
Dr./Dr Isra Levy,
Medical Officer of Health/Médecin chef en santé publique
Contact Person / Personne ressource:
Sherry Nigro, Manager/Gestionnaire
Health Promotion and Disease Prevention/Promotion de la santé et prévention des
maladies
Ottawa Public Health/Santé publique Ottawa
613-580-2424, ext./poste 28971, [email protected]
CITY WIDE / À L’ÉCHELLE DE LA VILLE
Ref N°: ACS2013-OPH-HPDP-0001
SUBJECT:
UPDATE ON BABY-FRIENDLY INITIATIVE DESIGNATION
OBJET :
LE POINT SUR LA DÉSIGNATION DE L’INITITIVE AMI DES BÉBÉS
REPORT RECOMMENDATIONS
That the Board of Health for the City of Ottawa Health Unit receive this report for
information.
RECOMMANDATIONS DU RAPPORT
Que le Conseil de santé de la circonscription sanitaire de la ville d’Ottawa prenne
connaissance du présent rapport à titre d’information.
EXECUTIVE SUMMARY
Breastfeeding has proven health benefits for infants, mothers and families. In addition to
preventing illnesses such as obesity and diabetes later in life, providing breast milk
reduces the risk of childhood illnesses such as respiratory and middle ear infections and
sudden infant death syndrome. That’s why, in 2012, Ottawa Public Health (OPH) began
working with the Breastfeeding Committee for Canada towards formal Baby-Friendly
Initiative (BFI) designation, a process established by the World Health Organization to
create supportive environments in front-line services, workplaces and in the community
to increase awareness of the benefits of breastfeeding and encourage the provision of
breastmilk.
Over the course of the last year, OPH underwent assessments and successfully
implemented elements required for formal designation. In submitting to such a rigorous
assessment process, OPH continues to improve the supports, programs and services it
provides to families in the community in order to promote, protect and support early
childhood development and breastfeeding.
While breastfeeding rates in Ottawa exceed those in Ontario and Canada, OPH and
community partners continue to strive for improvement by creating conditions that allow
mothers to breastfeed anytime, anywhere. OPH and its partners are proud to promote,
protect and support breastfeeding in Ottawa through prenatal education, support dropins, peer support programs, home visits, and the provision of evidence-based infant
feeding information to parents. In 2013, OPH will continue to formalize and enhance
operations and program planning related to early childhood development and infant
feeding, and will continue to strengthen organizational capacity, identify opportunities to
promote breastfeeding, conduct ongoing infant feeding surveillance and collaborate with
other community health services. Achieving BFI designation is a Public Health
Accountability Agreement and OPH is on schedule to meet the target for designation in
2013. This will occur through ongoing collaboration with the Breastfeeding Committee
for Canada.
RÉSUMÉ
Les avantages de l'allaitement maternel pour les nourrissons, les mères et les familles
sont démontrés. En plus de prévenir des maladies comme l'obésité et le diabète plus
tard dans la vie, le lait maternel diminue les risques de maladies infantiles comme les
infections des voies respiratoires et de l'oreille moyenne et la mort subite du nourrisson.
C’est pourquoi en 2012, Santé publique Ottawa (SPO) a commencé à travailler avec le
Comité d’allaitement pour le Canada vers la désignation formelle de l’initiative
Ami des bébés, un processus établi par l’Organisation mondiale de la santé afin de
créer des milieux favorables à l’allaitement dans les services de première ligne, les lieux
de travail et la collectivité, de sensibiliser ainsi davantage la population aux bienfaits de
l’allaitement et d’encourager l’allaitement maternel.
Pendant la dernière année, SPO a mené des évaluations et est parvenue à mettre en
place les éléments nécessaires à la désignation formelle. En se soumettant à un
processus d’évaluation aussi rigoureux, SPO continue d’améliorer les formes de
soutien, les programmes et les services qu’il met à la disposition des familles de la
collectivité afin de promouvoir, de protéger et de favoriser le développement de la petite
enfance et l’allaitement.
Bien que les taux d'allaitement maternel dans Ottawa soient supérieurs à ceux de
l'Ontario et du Canada, SPO et ses partenaires communautaires s'efforcent toujours
d'améliorer la situation en créant des conditions propices à l’allaitement en tout temps et
peu importe l’endroit. SPO et ses partenaires sont fiers de promouvoir, de protéger et
de soutenir l'allaitement maternel dans Ottawa en offrant des programmes d'éducation
prénatale, des services de halte-accueil, des programmes d'entraide, des visites à
domicile, et en fournissant aux parents de l'information validée sur l'allaitement des
nourrissons. En 2013, SPO continuera de formaliser et d’améliorer les opérations et la
planification des programmes liés au développement de la petite enfance et à
l’alimentation infantile, et il continuera d’accroître la capacité organisationnelle, de
cerner des possibilités de promotion de l’allaitement, d’exercer une surveillance
continue de l’alimentation infantile et de collaborer avec d’autres services de santé
communautaires. La désignation de l’initiative Ami des bébés s’inscrit dans l’Entente de
responsabilité de la santé publique et SPO est en bonne voie d’atteindre l’objectif de
désignation fixé pour 2013. À cette fin, il collaborera de façon continue avec le Comité
canadien pour l’allaitement.
BACKGROUND
Ottawa Public Health (OPH) and its partners promote breastfeeding for healthy growth
and development of infants. Providing breast milk decreases the risk of childhood illness
and of hospitalization related to a wide range of acute and chronic diseases, such as
respiratory and middle ear infection, diabetes, obesity, sudden infant death syndrome,
and other short and long term illnesses. Breastfeeding also benefits maternal health.
While breastfeeding rates in Ottawa exceed those in Ontario and Canada, as reported
to the Board last August (ASC2012-OPH-HPDP-0007), OPH has been working with the
Breastfeeding Committee for Canada towards achieving Baby-Friendly Initiative (BFI)
designation, a program established by the World Health Organization to promote,
protect and support the initiation and continuation of breastfeeding, as well as to break
down barriers to breastfeeding. Achieving BFI designation is a Public Health
Accountability Agreement Performance Indicator for the term January 1, 2011 to
December 31, 2013, as outlined in the Ottawa Board of Health Accountability
Agreement Report (ACS2011-OPH-IQS-0009). OPH is on schedule to meet the target
for designation in 2013. This will occur through ongoing collaboration with the
Breastfeeding Committee for Canada.
In working with the Breastfeeding Committee for Canada, OPH has:
Strengthened organizational capacity by updating policies, ensuring consistency
of information provided to new parents and by applying a Baby-Friendly lens to
all relevant OPH programs and services. In addition, all OPH staff, volunteers
and students participated in formal breastfeeding training.
Demonstrated leadership in the community by working with many agencies to
provide breastfeeding support services for families with new babies and young
children
Ensured that all parents in Ottawa have access to evidence-based information on
infant feeding and care practices to support informed decision-making
Began enhanced surveillance on infant feeding practices
In submitting to such a rigorous assessment process, OPH continues to improve the
programs and services it provides to families in the community in order to promote,
protect and support early childhood development and breastfeeding. These include:
Prenatal education
Postpartum telephone contact 48 hours after discharge from hospital
Postpartum home visits to new parents, based on need
Home visits to families experiencing challenges during the prenatal period and to
those with children up to the age of six years
Tele-nursing services through the Ottawa Public Health Information Line to
address questions and concerns regarding infant feeding and care practices, and
to refer families to support services
Baby Express Drop-Ins that provide assessment, support, referral and
information for new parents on feeding and care for children up to one year of
age
Ottawa Breastfeeding Buddies peer support program, which pairs expecting and
new moms with experienced moms, who offer support and guidance
Support to community partners who provide breastfeeding drop-ins
Partnership with Mothercraft to ensure Saturday breastfeeding support
Community-wide promotion events, such as the annual Breastfeeding Challenge
Growing Healthy screening clinics
DISCUSSION
The Public Health Accountability Agreement and the formal BFI designation are
important mechanisms in advancing breastfeeding rates, and subsequently improving
the health status of Ottawa’s infants and mothers. Initially assessed at an intermediate
level of readiness in January 2012, staff across OPH has worked towards the Ministry of
Health and Long-Term Care target of attaining an advanced level of readiness (2012
target). At this time, OPH has made marked progress with a view to achieving full BFI
designation in 2013. The process of achieving the BFI designation has improved OPH
capacity to promote, protect and support breastfeeding, and it is anticipated that this
work will sustain itself in stronger public policies, programming and partnerships for the
continued work ahead.
Informed Decision Making and Support for Breastfeeding
Key to successful breastfeeding is making the decision to breastfeed and having
support and information on infant feeding and care practices. It is expected that a new
OPH model for prenatal education, to be launched in January 2013, will ensure
information and support are available to families in their reproductive years and to
members of the extended family who are instrumental in supporting breastfeeding
women. The new model includes online classes, in-person classes with one session
entirely devoted to breastfeeding, and telephone follow-up with a public health nurse.
OPH will be monitoring carefully to evaluate the reach and impact of the service. OPH
also provides specialized prenatal education and support to at risk pregnant women.
Furthermore, OPH is expanding the Breastfeeding Buddies program, recruiting and
training new volunteers to provide additional support to moms at the end of pregnancy
or just after baby is born.
Collaboration with Community Agencies
Excellent referral liaison relationships between the child-birthing hospitals and the
OPH’s Healthy Babies, Healthy Children (HBHC) Program ensure that more than 98 per
cent of new moms are referred to HBHC and receive a telephone call from a public
health nurse within 48 hours of discharge from hospital. If needed, a home visit from a
public health nurse is offered. In the recent BFI assessment, this was emphasized as a
strength for OPH with a strong recommendation to maintain this service.
Consistency of information and easy, timely access to assistance and nursing care are
vital parts of breastfeeding support, especially for mothers who are experiencing
challenges. OPH works with hospitals, Community Health and Resource Centres, the
Ottawa Public Library, and other community partners to provide Baby Express drop-in
services, including weekend service, to ensure available support for all new mothers
experiencing challenges. Recently, partners have been actively working with OPH to
ensure a drop in for both days on the weekend, an expansion to better serve young
families experiencing difficulty with breastfeeding and other infant feeding issues. OPH
tele-nursing services are also part of this safety net to provide assistance to young
families, with 20 per cent of calls attributed to questions about breastfeeding.
Opportunities for Breastfeeding Promotion
OPH has services and programs to protect, promote and support breastfeeding outside
clinical settings and is also strengthening outreach to community agencies by working
with non-health agencies, including child care centres and restaurants, to encourage
support for breastfeeding in their facilities. This will help strengthen acceptance of
breastfeeding in the community and be more supportive of young families.
OPH will continue to share key messages with the community:
Encourage breastfeeding anytime, anywhere
Promote exclusive breastfeeding for the first six months, and continued
breastfeeding with the addition of complementary foods up to two years and
beyond
Promote breastfeeding for healthy growth and development
Support families in making informed decisions regarding infant feeding practices
OPH social media channels will continue to highlight these and other key messages for
breastfeeding success and the availability of community support. In addition, OPH will
continue to participate in the annual Breastfeeding Challenge to show support for
breastfeeding families. OPH is also working with City of Ottawa colleagues to establish
a breastfeeding room at Ottawa City Hall, as is currently available at 100 Constellation,
that will be available to staff and members of the public. While OPH supports
breastfeeding anytime, anywhere, it recognizes that some mothers prefer privacy when
breastfeeding or when expressing breast milk.
Increasing organizational capacity
In working towards formal BFI designation, OPH implemented the BFI Integrated 10
Step Practice Outcome Indicators for Hospitals and Community Health Services.
Actions to date include:
Training approximately 900 staff, students and volunteers through an on-line training
module. Staff who provide direct care to young families were given opportunities to
enhance knowledge and skills through direct observational experiences, an in-depth
on-line breastfeeding module and a clinical skills update session. All new
employees, students and volunteers will complete mandatory basic training, with
more in-depth learning experiences and continued training to be offered to staff and
students working directly with families with young children.
Implementing policies to protect, promote and support breastfeeding. These policies
help employees and visitors to OPH to meet their breastfeeding goals. Employees
wishing to breastfeed after returning to work and mothers wanting private space to
breastfeed or express breast milk are supported by OPH. The policies also address
the importance of supporting all families regardless of their chosen feeding method
and help families to make informed decisions.
Applying a Baby-Friendly lens to all relevant OPH programs and services. All OPH
resources, communications and professional client interactions have been reviewed
to ensure consistency with BFI principles and practices (Documents 1-4).
Demonstrating leadership in the community by working with many agencies to
provide breastfeeding support services for families with new babies and young
children
Conducting enhanced surveillance on infant feeding practices.
Assessment results indicated that OPH is well positioned to achieve and sustain BFI
designation in 2013.
CONSULTATION
Work towards BFI designation and breastfeeding promotion has been informed by
community partners. As OPH continues to implement the BFI, partners will be engaged
through various committees, including the Champlain Maternal Newborn Regional
Program and the “Ontario Baby-Friendly Initiative in Community Health Services”
Committee.
LEGAL IMPLICATIONS
There are no legal impediments to receiving the information in this report.
FINANCIAL IMPLICATIONS
There are no financial implications associated with this report.
TECHNOLOGY IMPLICATIONS
There are no new technology implications associated with this report.
BOARD OF HEALTH STRATEGIC PRIORITIES
The recommendations in this report support the Board of Health Strategic Priorities: A1
Applying a health lens to all municipal policies; A4 Increasing community participation
and engagement; B1 Increasing nutrition skills in priority populations; D4 Increasing
programming to support healthy child development.
TERM OF COUNCIL PRIORITIES
The recommendations in this report support the Term of Council Priority: Healthy and
Caring Communities
SUPPORTING DOCUMENTATION
Document 1 – Breastfeeding and Contraception
Document 2 – Hand Expressing Breast Milk
Document 3 – How Do I Know If My Baby Is Hungry?
Document 4 – Skin-to-Skin: Get to Know Your Baby. Let Your Baby Know You
DOCUMENTS À L’APPUI
Document 1 – Allaitement et contraception
Document 2 – Expression manuelle du lait maternel
Document 3 – Comment savoir si mon bébé a faim?
Document 4 – Peau-à-peau : apprenez à connaître votre bébé et laissez-vous connaître
de lui aussi
DISPOSITION
Ottawa Public Health will continue to promote, protect and support early childhood
development and breastfeeding in Ottawa and ensure continuous organizational
improvement through achieving formal BFI designation.