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

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

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

4. 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

5. 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

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

7. 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

8. 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

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

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

11. 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

12. 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

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

14. Web Links Public Health Manuals http://www.ehealthsask.ca/services/manuals/Pages/de fault.aspx http://www.ehealthsask.ca/services/manuals/Pages/de fault.aspx Growing Up Healthy pamphlet series http://www.saskatchewan.ca/live/health-and-healthy- living/health-topics-awareness-and- prevention/children-health-and-parenting/growing-up- healthyhttp://www.saskatchewan.ca/live/health-and-healthy- living/health-topics-awareness-and- prevention/children-health-and-parenting/growing-up- healthy.

15. Thank you ! For more information contact: Laura Matz RN, BSN, MPH Population Health Branch Ministry of Health laura.matz@health.gov.sk.ca 306-787-6921