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Being Baby Friendly

We support women's informed choices about infant feeding.
Being Baby Friendly

Being Baby-Friendly

BC Women’s Hospital + Health Centre is Baby-Friendly, which means we proudly support women’s informed choices about infant feeding. 

Many things influence the infant feeding choices women make, including attitudes and beliefs of the people around her, personal experiences, and complete (or incomplete) information about the choices available.

Our goal is to be part of a system that enables women to get as much information and support as they need to make choices they are comfortable with. We are committed to following World Health OrganizationHealth Canada, and Perinatal Services BC recommendations on infant feeding.

From January 16 - 19, 2017, Baby Friendly Initative (BFI) assessors will be onsite at the hospital to review BC Women's BFI hospital designation outlined by WHO and UNICEF.

This global initiative from WHO/UNICEF encourages health care providers to give care based on the best available evidence to support families to make informed infant feeding choices. Based on The Ten Steps to Successful Breastfeeding, this initiative directs system-wide changes to eliminate barriers for families. 

Today, most families want to breastfeed. This initiative helps those families and supports families who have made informed decisions to bottle feed to safely do so. As a result, Baby-Friendly doctors/midwife offices benefit all families.

Ten Steps to Being Baby-Friendly

  1. Support, promote, and protect breastfeeding by informing women, so they can make informed decisions about infant feeding.
  2. Establish a baby-friendly office policy in collaboration with your colleagues and office staff and inform all new staff of this policy.
  3. Refrain from distributing free formula to women in your office.
  4. Ensure that your patient education material and magazines do not advertise breast-milk substitutes, bottles, or nipples.
  5. Display baby-friendly posters that promote breastfeeding.
  6. Provide a relatively private area in your office where babies can be breastfed.
  7. Do not refer pregnant women to formula company–run prenatal or postnatal classes.
  8. Eliminate the practice of accepting free samples of breast milk substitutes or related materials by your office staff.
  9. Advocate to ensure that the hospital where you provide services is a “baby-friendly hospital.”
  10. Support continued breastfeeding among mothers who return to workplaces outside their homes by advocating for baby-friendly workplaces. Ensure that your office is a baby-friendly workplace for your own staff.
Q&A

Q&A for professionals

Top baby-friendly questions and answers that physicians, midwives, and other health care professionals should know.

Printable version 30 Baby-Friendly Q&As

Top 10 Baby-Friendly Questions:  

Q. What are the expert recommendations about exclusive breastfeeding and duration?

A. Expert recommendations are: Six months of exclusive breastfeeding, with solids introduced at about six months and breastfeeding continuing for two years or beyond.

Q. What are some of the benefits of breastfeeding?

A. Breast milk is a living tissue that provides numerous immunological benefits as well the appropriate species-specific food. Benefits of breastfeeding are optimal health and nutrition (less risk of many infections, including gastro-intestinal, middle ear, upper respiratory, meningitis, NEC; less risk of certain illnesses and chronic conditions, such as allergies, diabetes, and certain childhood cancers) and optimal cognitive development. Breastfeeding enhances maternal infant bonding and has numerous benefits to mothers including weight loss, decreased risk of postpartum bleeding, and decreased risk of breast cancer. Financial benefits: it’s free, and breastfed children require fewer antibiotics and other health care interventions. Parents also take less time off work to address the needs of their sick children.

Q. What are some key points about getting breastfeeding off to a good start?

A. Place baby skin-to-skin at delivery – when cuing behaviours begin assist with breastfeeding. Leave the mother and baby undisturbed throughout this initial feeding attempt. Encourage lots of skin-to-skin contact and frequent breastfeeding attempts. Support the mother to latch her baby well and to identify early feeding cues. Use positive language to empower mother and her baby.

Q. Why is skin-to skin care important?

A. Benefits of skin-to-skin care include thermoregulation, decreased newborn stress, enhanced homeostasis, decreased infant crying, stimulation of hormonal regulation of lactation, and increased maternal milk production.

Q. What percentage of mothers do you teach hand expression?

A. 100% of breastfeeding mothers. Hand expression includes expressing a few drops of colostrum to entice baby, to stimulate lactation in the first 24-48 hours when pumping may not be as efficient, or to empty breasts instead of using a pump.

Q. What are some medical indications for supplements?

A. For babies who are well enough to be with their mothers during postpartum, there are very few indications for supplements. The medical indications for supplementation are:

  • infants with acute water loss, for example during phototherapy for jaundice, if increased breastfeeding cannot provide adequate hydration;
  • infants whose clinical condition (hypoglycemic) indicates a need for additional calories which is not met by additional breastfeeding;
  • infants whose mothers are severely ill (for example with psychosis, eclampsia, or shock);
  • infants with inborn errors of metabolism (e.g. galactosaemia, phenylketonuria, maple syrup urine disease);
  • infants whose mothers are taking medication which is contraindicated when breastfeeding (e.g. cytotoxic drugs, radioactive drugs, anti-thyroid drugs other than propylthiouracil);
  • infants who have not regained birth weight at two to three weeks of age or who have insufficient weight gain, when increased effective breastfeeding cannot provide adequate intake. 

Q. What do you suggest to mothers when their babies are fussy, especially at night?

A. Reassure mothers that it is common for babies to feed frequently at night. When the baby is ‘fussy’, keep baby skin-to-skin and feed frequently.

Q. What are some of the community resources available for breastfeeding mothers?

A. Resources in the community include La Leche League, mothers groups, and community health units that provide community health nurse visits and mothers groups. BC Women's also has outpatient breastfeeding clinics.

Q. What do you suggest to families to help their babies when they have painful procedures such as heel pricks?

A. Evidence indicates that babies cope best with painful procedures (and use up less energy) if they are comforted throughout the procedure. Breastfeeding during these procedures significantly helps the baby. Other possibilities include offering the parents finger to suck on.

Q. What do you tell parents about typical feeding patterns and how they change over the first few days?

A. Babies will often feed soon after birth if left undisturbed, skin-to-skin on the mother’s chest. During the first 24 hours, they are often quite sleepy. In the second 24 hours, we expect that babies will become much more wakeful and interested in feeding – at least eight times in 24 hours. They may have clusters of feeds when they feed very frequently over a short period of time and then sleep for a longer period. Their output increases from a minimum of one wet diaper during the first 24 hours, two during the second, and increases markedly over the next couple of days as the milk supply increases. Stooling also increases, and the stool colour changes.

Supporting Patients

Supporting Informed Decisions

BC Women’s wants to ensure that we provide patients with information about infant feeding and that we respect the choices patients make.

BC Women's encourages patients and families to get as much information as they need and to ensure that their questions and concerns about breastfeeding have been answered.

The following hospital policies support families to breastfeed and to make informed decisions:

Infant Feeding Policy

BC Women's Infant Feeding Policy is consistent with the World Health Organization (WHO) and UNICEF's Ten Steps to Successful Breastfeeding and supports families to breastfeed and to make informed decisions

Policy Highlights

Women and Families:

  • Families are provided with information about infant feeding options, so an informed choice about breastfeeding can be made. Mothers choosing to breastfeed are actively supported as outlined in UNICEF's Ten Steps to Successful Breastfeeding.
  • Breastfeeding is initiated within 30 minutes after birth unless mother and/or newborn are medically unstable.
  • All mother-infant couples are to remain together during their hospital stay unless mother and/or baby are medically unstable.
  • Women making an informed choice to formula feed are provided with information and support.
  • Free samples of breast milk substitutes are not given to families to take home.

BC Women’s:

  • Operationally supports the development and implementation of systems and structures which create a culture conducive to breastfeeding.
  • Collaborates with the community on all aspects of infant feeding and provides leadership in defining "best practice."
  • Does not permit any literature, equipment, or other displays sponsored by manufacturers of breast milk substitutes at the facility.
  • Health care providers are expected to practice BC Women’s standards defined for infant feeding.

Ethical purchasing policy:

Our policy complies with the World Health Code of Marketing of Breast Milk Substitutes.

Canada signed this WHO agreement in 1991. The Code directs hospitals and health care providers to make decisions about purchase and use of formula (breast milk substitutes) based on clinical rather than advertising claims.

  • The code supports families to make informed decisions and ensures that families choosing to give formula get accurate information and a quality product correctly labelled.
  • We do not provide marketing information or samples to families.

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SOURCE: Being Baby Friendly ( )
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