Breastfeeding Policy

Policy: 

Peterborough Child and Family Centres recognizes that breastfeeding is the normal and unequalled method of feeding infants.  Exclusive breastfeeding during the first six months is accepted as the nutrition standard for infants according to the Dietary Reference Intakes and is promoted by the WHO as a global public health recommendation (IOM, 2006: WHO, 2003). All mothers have the right to make a fully informed decision as to how they feed and care for their babies.  The provision of clear and impartial information to all mothers at an appropriate time is therefore essential.

Staff providing direct breastfeeding support have the responsibility to support mothers and families once they have ensured that the family has received accurate infant feeding information.  This policy is designed to ensure good professional practice within the scope of the Family Centered Maternity and Newborn Care:  National Guidelines (Health Canada, 2017); RNAO Best Practice Guidelines for Nurses, 2018; and International Board of Lactation Consultant Examiners Professional Standards.

Purpose:  

  • To ensure that the health benefits of breastfeeding and the health risks of breast milk substitutes are discussed with all expectant women and their families as appropriate, so they can make an informed decision about how they will feed their babies.
  • To create an environment where more women choose to exclusively breastfeed their babies, and where all women are given sufficient information and support to enable them to breastfeed exclusively for six months and to continue breastfeeding with the addition of appropriate complementary foods for up to two years of age or beyond (Nutrition for Healthy Term Infants, 2014).
  • To enable all health care providers who have contact with breastfeeding women to provide full and competent support through specialized education and training in all aspects of breastfeeding management.
  • To support the development of a breastfeeding culture throughout PCFC.

IN SUPPORT OF THIS POLICY:

  • Adherence to this policy is required for all PCFC staff. The policy will be implemented in conjunction with the Breastfeeding Committee for Canada’s Baby-Friendly Initiative 10 Steps and WHO Code Outcome Indicators for Hospitals and Community Health Services (2017, Appendix 1.2-1).
  • This policy is directed towards the protection, promotion and support of breastfeeding for healthy mothers and babies and is in compliance with the “International Code of Marketing of Breastmilk Substitutes” (“The Code”) (Appendix 1.2-2).
  • The policy and any associated procedures or guidelines will be reviewed by the Chief Executive Officer and Team Managers when reviewing the PCFC Operational Policy Manual. Compliance with the policy will be monitored on an annual basis.

 

 

Procedure: 

1. Communicating the Breastfeeding Policy

  •  All new staff, volunteers and students will be oriented to the policy appropriate to their roles and responsibilities, during agency orientation.
  • Wherever PCFC service is provided, the abbreviated policy will be displayed in all public areas. The policy will also be accessible to women in a variety of forms, both written and on the PCFC website.

2. Education and Training of Staff

  •  Nurses and lactation consultants will have the primary responsibility for supporting breastfeeding women and for helping them to overcome related problems.
  •  All staff having contact with pregnant women and mothers will receive education and training in breastfeeding management at a level appropriate to their role. All staff will have education regarding the implementation of the breastfeeding policy, and further will receive training to:

i. Fully understand how The Code and BFI protect families against commercial pressure and protects, promotes and supports breastfeeding families.
ii. Ensure that the point of first referral within PCFC for breastfeeding help is the nursing staff.
iii. Identify professionals to refer mothers experiencing breastfeeding difficulties.

  • All new PCFC staff will complete the online breastfeeding training module, Healthy Mothers Healthy Babies Breastfeeding, at beststart.org within their probationary period.

3. Informing Pregnant Women of the Importance and Process of Breastfeeding

  • Every effort will be made to ensure that all pregnant women are aware of the importance of exclusive breastfeeding and of the health risks of breast milk substitutes.
  • All pregnant women who have contact with PCFC will be given an opportunity to discuss infant feeding on a one-to-one basis with a nurse and/or lactation consultant.
  • Prenatal education, when provided by PCFC, will include information to help women and their families make an informed decision about infant feeding. The basics of breastfeeding management and the common experiences they may encounter will also be included. The aim is to give women confidence in their ability to breastfeed.
  • All materials and teaching will reflect the WHO/UNICEF Baby FriendlyTM best practice standards of the Breastfeeding Committee for Canada Baby-Friendly Initiative Ten Steps and WHO Code Outcome Indicators for Hospitals and Community Health Services guiding principles.

4. Supporting Skin to Skin Contact

The natural habitat for newborn babies is skin to skin with their mother. Immediate and uninterrupted skin to skin contact is an integral part of establishing breastfeeding and is essential to an infant’s stability regardless of feeding method. Skin to skin contact beyond the immediate postpartum period continues to benefit all babies and mothers. PCFC will support expectant families and families with newborns with information in support of skin-to-skin contact.

5. Assisting Mothers to Breastfeed and Maintain Lactation

  • PCFC will provide breastfeeding support through a number of venues, including a Breastfeeding and Well Baby Clinic where all mothers have the opportunity for early assessment of breastfeeding. Follow up plans will be determined on an individual basis by the nurse/lactation consultant in consultation with the mother. All mothers who request information, support and/or assessment of breastfeeding will be referred to the PCFC nursing staff.
  • Nurses and Lactation Consultants will ensure that mothers are able to correctly position and latch their babies to the breast and assess for adequate hydration and milk intake.
  • PCFC will provide all mothers with information on how to access community-based breastfeeding and parenting support on a 24-hour basis through the Breastfeeding and Well Baby Clinic, Peterborough Regional Health Care Centre’s Breastfeeding Clinic and La Leche League.

6. Support Mothers to Exclusively Breastfeed for the First Six Months

  • PCFC will support evidence-based practices, which are known to facilitate the initiation and establishment of exclusive breastfeeding for six months, such as keeping baby near, cue-based feeding and avoiding non-medically indicated supplements.
  • Nurses and Lactation Consultants will ensure that all breastfeeding mothers will be shown how to hand express their milk and be provided with detailed information on hand expression, and if required, the use of breast pumps.
  • Nurses and Lactation Consultants will provide evidence-based information on safe and alternative feeding methods should a supplement be medically indicated.

7. Mothers and Infants Remain Together

  • Families will be given information about the importance of mom and baby remaining together including sleeping in the same room.
  • Mothers with breastfeeding infants will be supported to remain together while in PCFC programs.
    Prenatal families will be given information about 24-hour hospital rooming in.
  • PCFC will support Peterborough Regional Health Care with their rooming in policy by participation in community committees such as the breastfeeding coalition.

8. Baby Led Feeding and Sustained Breastfeeding

  • PCFC infant programs will emphasize the importance of infant cues as the most accurate way to determine hunger and satiety.
  • Services will reflect the aim of exclusive breastfeeding to six months and continued breastfeeding beyond six months with appropriate introduction of complementary foods as per Nutrition for Healthy Term Infants 2014.
  • Parents will be informed about their right to have accommodations in the workplace that support and sustain breastfeeding.

9. Artificial Teats or Pacifiers

  • Information regarding the risks to using artificial teats or pacifiers will be given to prenatal and breastfeeding families.
  • Breastfeeding families will receive support and information on soothing baby without the use of artificial teats or pacifiers.
  • Nurses / Lactation Consultants will provide information on feeding alternatives (eg. cup or spoon) if supplemental feedings are required.

10. Breastfeeding Support in the Community

  • PCFC encourages collaboration with other health care providers and community based breastfeeding support programs.
  • PCFC recognizes the important role peer support plays in breastfeeding success and will, when possible, integrate the role of peer support mothers into programs and services. PFRC will continue to foster relationships with community partners who offer peer support services by offering resources such as meeting space, photocopying, etc. when appropriate.
  • PCFC staff will use their influence to advocate for a breastfeeding culture in the Peterborough area through collaborative partnerships with community groups, businesses, schools, local government and the media.
  • PCFC will participate in community committees and projects that promote and develop breastfeeding services and supports for families.

Appendix 1.2-1 – BFI Ten Steps and WHO Code Outcome Indicators for Hospitals and Community Health Services
For the protection, promotion and support of breastfeeding in Community Health Care Settings, all providers of community health care will:

      1. Have a written breastfeeding policy that is routinely communicated to all health care providers and volunteers.
      2. Ensure all staff, health care providers and volunteers have the knowledge and skills necessary to implement the infant feeding policy.
      3. Inform pregnant women and their families about the importance and process of breastfeeding.
      4. Place babies in uninterrupted skin-to-skin contact with their mothers immediately following birth for at least an hour or until completion of the first feeding or as long as the mother wishes. Encourage mothers to recognize when their babies are ready to feed, offering help as needed.
      5. Assist mothers to breastfeed and maintain lactation should they face challenges including separation from their infants.
      6. Support mothers to exclusively breastfeed for the first six months, unless supplements are medically indicated.
      7. Facilitate 24-hour rooming-in for all mother-infant dyads: mothers and infants remain together.
      8. Encourage responsive, cue-based feeding. Encourage sustained breastfeeding beyond six months with appropriate introduction of complementary foods.
      9. Support mothers to feed and care for their breastfeeding babies without the use of artificial teats or pacifiers (dummies or soothers)
      10. Provide a seamless transition between the services provided by the hospital, community health services, and peer-support programs. Apply principles of primary health care and population health to support the continuum of care and implement strategies that affect the broad determinants that will improve breastfeeding outcomes.
      11. Compliance with the WHO International Code of Marketing of Breastmilk Substitutes.

    Appendix 1.2-2 – World Health Organization International Code of Marketing of  Breastmilk Substitutes (the “Code”) 

      1. No advertising of infant formula, pacifiers or feeding bottles to the public.
      2. No free samples to mothers.
      3. No promotion of infant feeding products (e.g. by notepads, booklets, posters, displays) in health care facilities.
      4. No formula company representatives to advise mothers.
      5. No words or pictures idealizing artificial feeding, including pictures of infants, on the labels of the products.
      6. All information on artificial infant feeding, including the labels, should explain the benefits of breastfeeding, and the costs and hazards associated with artificial feeding.
      7. Unsuitable products, such as sweetened condensed milk and evaporated milk, should not be promoted for babies.
      8. No gifts or personal samples should be given to health workers.
      9. Information to health workers should be scientific and factual.
      10. All products would be of a high quality and take account of the climatic and storage conditions of the country where they are used.
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