D4 1 breastfeeding support highlighting leading practice initiatives that work with the community

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

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Arrived in Toronto on June 15th, 2014

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Experience with: 

NICU

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Premature delivery

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bottle feeding Languages spoken:

 

Dari



Urdu



Persian



Hindi

Community Breastfeeding Peers Susan 

Mother to Evelyn



Arrived in Toronto February 2012

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Languages spoken:





Indonesian



Malay



Mandarin

Experience with: 

mental health concerns



outreach

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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

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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

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"I learned from other experienced mother's who have breastfed before" - participant

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70% report they plan to breastfeed longer than expected as a result of attending the program

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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

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Breastfeeding directly, skin-to-skin, with no use of bottle

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More playing- dancing and singing

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Increasing physical touch with baby (more skin to skin contact)

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Breastfeeding in public (on demand)

Peer Breastfeeding Education Programs La Leche League Canada 

Leaders throughout Ontario

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Toolkits, information sheets, seminars

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lllc.ca

Best Start Resource Centre 

Healthy Mothers, Healthy Babies breastfeeding course

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Breastfeeding Peer Support Training: Train-the-Trainer

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beststart.org/services/training

Community Partners:

Thank you!

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