Communities at the Centre: Supporting Breastfeeding June 2018
Presenters: Catherine Pestl and Clare Ambraska Relationships to commercial interests: none
Presenters and/or FHC does not have any know conflicts of interest
Learning Objectives: •
• •
Learn about community based strategies that support breastfeeding Identify strategies to address social isolation and post partum support Explore the use of Peer Breastfeeding Support model
Flemingdon Health Centre’s Breastfeeding Supports: Participation in local breastfeeding initiatives Prenatal partnerships Breastfeeding clinic
Breastfeeding support groups:
Ontario Trends 90% of mothers initiated some breastfeeding 60% of mothers were breastfeeding exclusively at discharge 30% of mothers breastfed exclusively for 6 months or longer
low rate of prenatal intention to breastfeed = low rate of initiation
(BORN data, 2013/2014)
Populations with lower breastfeeding rates Women with less education Women with lower incomes Newcomer women Women lacking social support Women with low breastfeeding knowledge, confidence, or intentions Women with poor physical or mental health during pregnancy Best Start, 2016
Baby friendly initiative (BFI) Integrated 10 Steps 1. 2. 3.
Have a written infant feeding policy Ensure that staff have sufficient knowledge, competence and skills Discuss the importance and management of breastfeeding with pregnant women and their families 4. Facilitate immediate and uninterrupted skin-to-skin contact 5. Support mothers to initiate and maintain breastfeeding and manage common difficulties 6. Do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated 7. Practice rooming-in 24 hours a day 8. Support mothers to recognize and respond to their infants’ cues 9. Counsel mothers on the use and risks of feeding bottles, teats and pacifiers 10. Coordinate discharge so that parents and their infants have timely access to ongoing support and care
WHO & Unicef 1989
Building Breastfeeding Support • Start prenatally • Account for transportation barriers, images that women relate to, literacy levels • Involve community stakeholders: • Agencies and community members • Create a process of engaging mothers: Individual + group conversations + outreach = a true reflection of the community • Empower women to solve problems and facilitate access to other resources: campaigns, groups, organizations and info about breastfeeding in the community
Have you had any experience working with peer support within your practice? 50%
No
Ye s
A. Yes B. No
50%
Breastfeeding Peer Support • Peers support breastfeeding in a culturally appropriate way • Reduces barriers
• Provides positive role models • Increases social connectedness • Familiarity and comfort level with a “non-professional” • Increases confidence and enhances communication skills
• Provides social support to prevent onset or further development of mental health concerns
• Peers completed breastfeeding education from Best Start and La Leche League programs
Community Breastfeeding Peers Madina
Mother to sarah, x, and another on the way
Arrived in Toronto on June 15th, 2014
Experience with:
NICU
Premature delivery
bottle feeding Languages spoken:
Dari
Urdu
Persian
Hindi
Community Breastfeeding Peers Susan
Mother to Evelyn
Arrived in Toronto February 2012
Languages spoken:
Indonesian
Malay
Mandarin
Experience with:
mental health concerns
outreach
nursing older children
Community Breastfeeding Peers Clare Mother to Eli Experience with:
breastfeeding toddlers breastfeeding while pregnant dealing with breastfeeding challenges infant attachment Flemingdon Health Centre staff Completed Lactation Educator Training
Community Breastfeeding Peers
Injila
Mother to Mudasen, Mehnaz, and Miriam
Immigrated to Canada and settled in Toronto, in Thorncliffe Park
Experience with:
Feeding interventions
Nursing during pregnancy
Impact: Breastfeeding Support Groups First Breastfeeding Support Group (BFSG) set up in Thorncliffe Park in
early 2013 Collaboration between Flemingdon Health Centre (FHC)/The Neighbourhood Office (TNO)/Toronto Public Health (TPH) and Health Access Thorncliffe Park (HATP) Breastfeeding Action Group, consisting of the above organizations, created to provide the overall direction for initiative Pilot project for 6 months; September 2013 Final Evaluation Report (TPH) Group has continued uninterrupted for 5 years Stats from 2013-2017: Over 1200 breastfeeding babies Almost 250 pregnant women
Impact: Breastfeeding Support Groups Model site for other collaborative units: AccessPoint Danforth Black Creek CHC Scarborough Village Mall Victoria Park Hub Set up in early 2015 Immediately following CPNP 3 peer leaders trained Almost 550 breastfeeding babies 350 pregnant women
Impact: Breastfeeding Support Groups Evaluation Highlights:
"the only reason I continue to breastfeed my 2 year old is because of the support of this group" - participant
"I learned from other experienced mother's who have breastfed before" - participant
70% report they plan to breastfeed longer than expected as a result of attending the program
54% of respondents report behaviour change and as a result doing something different (behavioural change) with their children as a result of attending the drop-in program.
Not keeping a feeding schedule and instead breastfeeding on demand
Breastfeeding directly, skin-to-skin, with no use of bottle
More playing- dancing and singing
Increasing physical touch with baby (more skin to skin contact)
Breastfeeding in public (on demand)
Peer Breastfeeding Education Programs La Leche League Canada
Leaders throughout Ontario
Toolkits, information sheets, seminars
lllc.ca
Best Start Resource Centre
Healthy Mothers, Healthy Babies breastfeeding course
Breastfeeding Peer Support Training: Train-the-Trainer
beststart.org/services/training
Community Partners:
Thank you! Comments, Questions and Feedback- connect with us! Flemingdon Health Centre info@fhc-chc.com Visit us at www.fhc-chc.com