Breastfeeding? The Health Unit Wants To Know

Breast feeding (Photo by © Can Stock Photo / Artranq)

An online tool is helping the Chatham-Kent Public Health Unit (CKPHU) figure out how many mothers in the community are breastfeeding their babies and which ones need some extra help getting their little one to latch on.

On June 10, 2016, the CKPHU was officially re-designated a “Baby Friendly” Community Health Facility by the Breastfeeding Committee for Canada, the national authority for the Baby Friendly Initiative (BFI) using the “10 Steps & WHO Code Practise Outcome Indicators for Hospitals and Community Health Services” criteria.

BFI is a program that helps to ensure all women have the opportunity to make an informed decision on how to feed their baby. It includes a ten-step plan that summarizes the maternity practices necessary to support breastfeeding:

  1.  Having a written infant feeding policy that is routinely communicated to staff, students, and volunteers
  2. Ensure all staff, students, and volunteers have the knowledge and skills necessary to implement the infant feeding policies
  3. Inform pregnant women and their families about the importance and process of breastfeeding
  4. Allow time for uninterrupted skin-to-skin contact with mothers and babies for at least an hour after birth
  5. Assist mothers to breastfeed and maintain lactation should they face challenges including separation from their infants
  6. Support mothers in exclusively breastfeeding for the first six months, unless supplements are medically required
  7. Facilitate 24-hour rooming for mothers and their babies to stay together
  8. Encourage responsive, cue-based feeding.
  9.  Support mothers to feed and care for their babies without the use of artificial teats or pacifiers
  10. Provide a seamless transition between services provided by the hospital, community health services, and peer support programs

As part of the program, the Infant and Child Health Team implemented the BFI Online Surveillance system on September 1, 2016.

Infant and Child Health Program Manager Marnie Van Vlymen says the online tool is a surveillance system to survey mothers in the community about whether they are breastfeeding, and where different skill supports are coming from.

Consent to participate in BFI Online is obtained from new mothers in the hospital prior to discharge. Mothers will then be sent the online survey through personal email. They also have the option to receive a telephone call to complete the survey. Surveys are sent to mothers when their babies are 2, 6, and 12 months of age.

During the first year, 453 mothers consented to participate in the surveillance system. Between September 1, 2016 to August 31, 2017, the percentage of mothers who reported providing breast milk at least once to their baby since birth was 92.7%.

According to the survey, 47.6% of mothers reported using programs and services to support feeding their baby.

Vlymen says the tool has found that more mothers seek skill support from community sources, rather than their family doctors.

“The physicians are definitely talking to the moms about the feeding in terms of the nutrition for the baby and how the baby is growing,” explains Vlymen. “But the latching positioning and the milk supply and all of that, they’re looking to the community for those supports.”

Vlymen says within the Healthy Babies Healthy Children program, the health unit contacts every mother within 48 hours of being released. She says support services and information are discussed during that conversation.

She says the most important time period to give information about breastfeeding is during a woman’s pregnancy.

“During pregnancy is when moms are gathering information and really making the biggest kind of decision of their feeding,” says Vlymen. “Most mothers know when they go into the hospital to give birth to their baby their plan for feeding.”

According to survey results, the largest drop in exclusive breastfeeding rates is between 3.5 and 4.5 months. Vlymen says the “biggest drop-offs” in the survey results occur when mothers aren’t producing enough milk to exclusively breastfeed.

“They’re at time periods where babies are often in not natural growth spurts, so the babies are feeding more. It’s recognized often by the moms saying ‘I don’t have enough milk to support this feeding,'” she says.

Vlymen says the growth spurt often inadvertently increases the milk supply to satisfy that growth spurt, but moms tend to think the baby is feeding more because it’s not getting enough. She says it’s important to teach mothers that sometimes babies feed more to naturally increase the milk supply they need.

One of the program’s aims is to have a 75% exclusive breastfeeding rate of babies after being released from the hospital.

Vlymen says the health unit will continue to work on the surveillance tool and make improvements.

“The biggest things that we’re looking at is supporting mothers in continuing to breastfeed in the workplace, continuing with the supports that we’re giving that were recognized as our top community supports, and looking at some of our priority populations like our young moms,” she explains.