The Baby-Friendly Initiative: Protecting, promoting and supporting breastfeeding

Question 1

What are benefits of breastfeeding?

Answer 1

1. Decreased bacterial meningitis
2. Decreased bacteremia
3. Decreased diarrhea
4. Decreased respiratory tract infections
5. Decreased otitis media
6. Decreased UTI
7. Decreased hospitalizations
8. Decreased SIDS
9. Enhanced neurocognitive testing
10. Decreased maternal breast and ovarian cancer
11. Increased postpartum weight loss
12. Improved cost

Question 2

What is the Global Strategy for Infant and Young Child Feeding Operational Targets from the Innocenti Declaration 2005?

Answer 2

1. Appoint a national breastfeeding coordinator with appropriate authority, and establish a multisectoral national breastfeeding committee composed of representatives from relevant government departments, non-governmental organizations and health professional associations.
2. Ensure that every facility providing maternity services fully practices all the “Ten steps to successful breastfeeding” set out in the WHO/UNICEF statement on breastfeeding and maternity services.
3. Give effect to the principles and aim of the International Code of Marketing of Breast-milk Substitutes and subsequent relevant Health Assembly resolutions in their entirety.
4. Enact imaginative legislation protecting the breastfeeding rights of working women and establish means for its enforcement.
5. Develop, implement, monitor and evaluate a comprehensive policy on infant and young child feeding, in the context of national policies and programs for nutrition, child and reproductive health, and poverty reduction.
6. Ensure that the health and other relevant sectors protect, promote and support exclusive breastfeeding for six months and continued breastfeeding for up to two years of age or beyond, while providing women access to the support they require – in the family, community and workplace – to achieve this goal.
7. Promote timely, adequate, safe and appropriate complementary feeding with continued breastfeeding.
8. Provide guidance on feeding infants and young children in exceptionally difficult circumstances, and on the related support required by mothers, families and other caregivers.

Question 3

What is the Baby Friendly Initiative?

Answer 3

A program that implemented the ten steps and WHO code provisions in facilities where babies and their mothers are cared for

Question 4

What are the integrated 10 steps practice outcome indicators?

Answer 4

Step 1: Have a written breastfeeding policy that is routinely communicated to all health care providers and volunteers.

Step 2: Ensure all health care providers have the knowledge and skills necessary to implement the breastfeeding policy.

Step 3: Inform pregnant women and their families about the importance and process of breastfeeding.

Step 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.

Step 5: Assist mothers to breastfeed and maintain lactation should they face challenges including separation from their infants.

Step 6: Support mothers to exclusively breastfeed for the first six months, unless supplements are medically indicated.

Step 7: Facilitate 24-hour rooming-in for all mother-infant dyads: mothers and infants remain together.

Step 8: Encourage baby-led or cue-based breastfeeding. Encourage sustained breastfeeding beyond six months with appropriate introduction of complementary foods.

Step 9: Support mothers to feed and care for their breastfeeding babies without the use of artificial teats or pacifiers (dummies or soothers).

Step 10: Provide a seamless transition among 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 determinations that will improve breastfeeding outcomes.

Question 5

What is the WHO International Code of marketing breast-milk substitutes?

Answer 5

1. No advertising of products to the public under the scope of the Code.
2. No free samples to be given to mothers.
3. No promotion of products in health care facilities.
4. No company representatives to advise women.
5. No gifts or personal samples to be given to health care workers.
6. No words or pictures idealizing artificial feeding, including pictures of infants, on the labels of products.
7. Information to health workers should be scientific and factual.
8. All information on artificial feeding, including that contained in product labels, should explain the benefits of breastfeeding and the costs and hazards associated with artificial feeding.
9. Unsuitable products, such as sweetened condensed milk, should not be promoted for babies.
10. All products should be of high quality and take account of the climatic and storage conditions of the country where they are used.
11. Promote and support exclusive breastfeeding for six months as a global public health recommendation with continued breastfeeding for up to two years of age or beyond.
12. Foster appropriate complementary feeding from the age of six months, recognizing that any food or drink given before it is nutritionally required may interfere with breastfeeding.
13. Complementary foods are not to be marketed in ways that undermine exclusive and sustained breastfeeding.

Question 6

What is the rate of exclusive breastfeeding at six months in Canada?

Answer 6

25.3-26%

Question 7

What are contraindications to breastfeeding?

Answer 7

1. Maternal HIV
2. Maternal use of cytotoxic chemotherapy
3. Maternal radiation therapy
4. Galactosemia
5. Relative: PKU

Question 8

What are the CPS Recommendations regarding BFI?

Answer 8

1. Breastfeeding should be protected, promoted and supported, since breast milk is the ideal form of nutrition for all infants and young children.
2. Governments should work to increase breastfeeding initiation, duration and exclusivity rates, given that breastfeeding confers important health, immunological, emotional and cognitive benefits for infants and young children.
3. All health care facilities and providers caring for mothers, infants and children should aim to adhere to BFI practices, which are known to increase the initiation, duration and exclusivity of breastfeeding.
4. Provincial/territorial ministries of health should mandate the development of a strategy for the implementation of the BFI in all health care facilities providing maternal/child health services, including hospitals, public health units, community health centres and physicians’ offices. A provincial- or territorial-level coordinator should be put in place to develop and coordinate the provincial/territorial BFI strategy.
5. A provincial/territorial breastfeeding education strategy should be implemented for all health care providers, managers and volunteers working in hospitals and community services that care for mothers and children.
6. Provinces and territories should each put in place a long-term, standardized data collection system for tracking breastfeeding initiation, duration and exclusivity rates.
7. Governments, health care facilities and health care providers should make every attempt to adhere to the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly Resolutions.