Incorporating BFI Messages Everyday Laura Matz, RN, BSN, MPH Public Health Nursing Consultant Ministry of Health April 2015

Supporting the BFI at a Provincial Level Process to include BFI in our resources Challenges faced going through this process Successes of our initiatives.

Saskatchewan Population: 1.1 million Geography: 1.8 people per sq. km 13 Regional Health Authorities 2 First Nations Jurisdictions

Provincial Focus Opportunity to review current processes and resources Appetite for standardizing client services and provider resources RHAs do not have time and capacity for individual review Initiated use of WHO Growth Charts provincially

Provincial Process Worked with interdisciplinary group – Nutritionists, Dental Health Educators, Public Health Nurses, Speech and Language Pathologists, Early Childhood Psychologists, Health Promotion Professionals, and Parents – Common language – Strong interest in working together Work reviewed by the Breastfeeding Committee for Saskatchewan

Challenges Working with interdisciplinary group – 7 different professions – Multiple years of experience – Many opinions and passions – Different understanding of BFI

Challenges Balancing breastfeeding as the normal way to feed with formula feeding as the most common way to feed in Saskatchewan – Breastfeeding initiation rates 86% in 2012 – Exclusivity rates at six months 31.9% in2012

Challenges Language used with health professionals and parents – Normalize breastfeeding – No breastfeeding instead of formula feeding – Supportive language – (removes “no, should, don’t”) – Shift to talking about the risks of formula feeding

Provincial Successes Child Health Clinic Guidelines for Standard Practice – Provincial guidelines – Nutrition assessment promotes breastfeeding and feeding relationships

Provincial Successes Provincial Implementation of WHO Growth Charts – Initiated in 2011 – Updated charts in 2014

Provincial Successes Nutrition and Growth Assessment Manual for Healthy Term Infants and Children (NAMIC) – Language and assessments supportive of BF Uses breastfed infant and non-breastfed infant terminology The breastfed infant is the standard reference point

Provincial Successes Growing Up Healthy pamphlet series – Series of seven pamphlets from newborn to six years of age – Provides anticipatory guidance for parents but does not replace the discussion – Reviewed to be BFI and meet International Code of Marketing Breast Milk Substitutes

Success Provincial Standardized Interdisciplinary development and review Ongoing scheduled review Engagement of health professionals using the resources

Web Links Public Health Manuals fault.aspx fault.aspx Growing Up Healthy pamphlet series living/health-topics-awareness-and- prevention/children-health-and-parenting/growing-up- healthyhttp:// living/health-topics-awareness-and- prevention/children-health-and-parenting/growing-up- healthy.

Thank you ! For more information contact: Laura Matz RN, BSN, MPH Population Health Branch Ministry of Health