Baby-Friendly Initiative Ontario

BFI in Community Health Services (CHS) Teleconference

Thursday February 11, 2016

9:00 a.m. – 11:00 a.m.

Minutes

Present:Lucy Bray (Simcoe Muskoka), Pamela Drynan (Porcupine), Laura Dueck (Middlesex-London),Sue Gierszewski (Halton), Debbie Godfrey (Durham), Kerri Grummett (Simcoe Muskoka), Heather Kane (Perth), Wendy Lahey (Wellington-Dufferin-Guelph), Heather Lawson (North Bay Parry Sound), Yolande Lawson (BFI Strategy), Grace Machado (Peel), Janice Magill (Oxiford), Jill Mather (Toronto) (Minutes), Tania O’Connor (Ottawa), Tracey Perri (Algoma), Evelyn te Nyenhuis (York ), Tammy Thomson (HKPR), Jenny Vandermeer (LGL) (Chair), Anna West (Halton), Jennifer Wyscaver (Elgin St. Thomas), Dawn Hanes ( PCCHU)

Item / Discussion / Decision/Action
  1. Welcome
/ Jenny is the new chair; thank you to Grace for her mentorship.
Additional agenda items:
3.7 BCC fee structure 2016
3.8 Emergency Response Planning
3.9 Breastfeeding Documentation Tools
3.10 OPHA
3.11 Breastfeeding and marijuana
3.12 Skin to skin
3.13 Reducing pain during vaccinations
  1. Review and approval of minutes of Oct 8, 2015
  2. Review
  3. Approval
/ ActionItem 3.3 Immunize.ca video
Jenny followed up with Tanis Brown, currently on maternity leave
Suggesting advocacy letter, bringing forward issue to Robin Merkley (Political Advocacy Person BFIO)
Action Item 3.5 Anna will arrange a teleconference in future
Action Item 3.6 Hot Topics webinars are listed on BFI Strategy for Ontario website,
-confusion re wording “at” or “about” six months
Marg La Salle advised to use at six months for population health level and at about six months for individual counselling, including signs of readiness / Minutes reviewed.
Minutes approved. No changes.
Jenny will bring this forward to BFIO Executive and Robyn Merkley
2.3Items to follow up from
June 2015 meeting / 3.4 Ages and Stages Questionnaire
Letter sent to producers, follow-up done and no response
3.5 Sleep Messaging
No chance to do yet, will keep as an action item for next meeting
LGL Health Unitis taking a harm reduction approach and has sent an advocacy letter to RNAO, will let group know results
RNAO has acknowledged some flaws in research
Janice discussed Kathleen Kendall Tackett’s presentation“Neuropsychological Effects of Sleep Training: Implications for Breastfeeding” is available for purchase. The cost was $16.00 US plus shipping. It can be ordered online at It can also be ordered by phone at 1-888-763-1464. The order number for that DVD is LC1543.
Concerns raised re sleep training/sleep doulas – babies coming into clinic with low birth weight
Michelle Branco (INFACT), Infant Mental Health Program (HSC) and others are developing some messaging, want to reach out to sleep training organizations / Jenny will provide update to group on behalf of LGL HU re. Safe sleep messaging and new resource developmentwhen complete
Evelyn provided the following link to Kathleen
Tackett’s presentation

3.0 New Business
3.1 Chair / Jenny is learning her new role, she is a PHN and LC at Leeds Grenville Lanark District Health Unit
3.2 Milk Sharing Resources / Wondering about milk sharing resources?
Awaiting response from Grace re follow up with BFIO Executive
What are other health units communicating?
Toronto developing guidelines for staff – in early stages at this point
Some health units are following Health Canada’s stance / Grace did send a message to BFI Ontario Executive (with members of the BCC at the table) – no response yet.
3.3 Jaundice Protocols / Evelyn discuss new jaundice protocols in hospitals
Found a reduction in exclusive breastfeeding rates in October and November since began use of jaundice protocols
Protocols are more stringent than previous
Skin to skin and hand expression teaching may help mitigate impact of new protocols.
Does anyone have similar stats? / Evelyn shared the following:
Regarding Jaundice Protocols, I believe these are the guidelines our local hospitals are implementing, identifying more babies “with risk” of hyperbillirubinimia

3.4 Evidence Informed Risks of not breastfeeding /Benefits of breastfeeding / Marg La Salle advised to continue to use key messages from Best Start
Stay tuned... WHO revising their docs which will come out at the end of the year
3.5 Progestin only hormonal contraception / No consensus on this topic in Peterborough area
Clinics are seeing a reduction in milk supply and can only relate it to progestin
Physicians say this is not possible
Dawn can’t find any research on this
Also experiencing push back about LAM, is this an issue in your community? Does anyone have any evidence re effectiveness of LAM?
Can reduction in milk supply be related to other variables? e.g. not feeding frequently
Anna recently updated Halton birth control resource and posted it on their website, she will look for research articles used
Some health units have message that progestin only pill “can” affect milk supply / Evelyn shared the following :
Regarding the effectiveness of LAM, here are a few references sited:
studies grouped on this page

(see section 15)
The birth control factsheet is on York Region’s website
search “birth control breastfeeding”
3.6 Methods of delivery of breastfeeding resources and evaluation / Has anyone looked at effectiveness of providing Breastfeeding Matters to hospitals?
Several health units distributing this resource pre and
post natally but no evaluations done to date.
Some hospitals are paying for the ones they are distributing
Some public health units are paying for the books and giving them to the hospitals
3.7 BCC fee structure 2016 / BCC Membership and BFIO Membership fees have a new structure, not done on a calendar year, based on your last payment, there are not a great deal of new registrants
BFI Designation Fees 2016 - Toronto inquired about this and stated that Toronto requires an invoice from the BCC in order to process / Jenny will follow up re BFI Designation Fees 2016; Michelle Le Drew may be the best contact.
3.8 Emergency Response Planning / London does training with emergency volunteers
York Region Emergency Preparedness Guide indicates that they accept formula donations or can purchase formula / London willing to share training
Evelyn will look into this :York Region does not actively accept formula donations, and volunteers are not encouraged to solicit them. Rather, if donations of formula have been dropped off, staff and volunteers are directed donate them to an appropriate resource, such as a Food Bank. Families involved in an emergency situation who require formula are provided with formula that has been purchased. This is all covered in the training that both staff and volunteers receive
3.9 Breastfeeding Documentation Tools / Are health units willing to share their tools? / Jill will inquire if she can share Toronto’s
Jenny willing to share Leeds Grenville tools **If you wish to adopt/adapt these resources, please contact Jenny for permission:

Porcupine Health Unit are sharing their tool:

3.10 OPHA / Anna from Halton discussed OPHA BF Promotion Workgroup – small group, looking for members
Require OPHA membership to join
Focus is position papers and advocacy
Will be looking into milk sharing this year; possibly develop a resource re informal milk sharing
Cathy Lowe and Heather Lawson are co-chairs
3.11 Breastfeeding and marijuana / Evelyn from York inquired whether any health units doing harm reduction messaging?
Thomas Hale and Toronto Public Health protocols advise against use.
York Region is consulting with Mother Risk and will await response. / York Region to provide response from Mother Risk.

3.12 Skin to skin / How to do skin to skin a safe way?
What research has been done on the safety of sleep belts?
Each comes with a fact sheet about safety.
Some health units teaching re use of a hospital gown to provide extra support during skin to skin. / Leeds Grenville developed a info graphic and fact sheet about safe sleep
This will be on display at Best Start conference, copies will be available there.

Infographic and complimentary FAQ sheet can be found on the LGL health unit. Please let Jenny know if you wish for permission to adopt.
3.13 Reducing pain during vaccinations / Immunization.ca suggests if baby can’t breastfeed to use sugar water and pacifier
Article that supports this will be shared with group
What resources are health units using for reduction of pain for vaccinations?
Ottawa has developed a resource and it is on their website.
Champlain Hospital has a module on the topic. / Update from Sonya Boersma: CMNRP, the Champlain Maternal Newborn Regional Program, developed the Newborn Pain Reduction poster
They also developed a Newborn Pain Management Self-Learning Module
Both of these will soon be on the new breastfeeding clearing house at joining CHEO’s (Children’s Hospital of Eastern Ontario) now updated Be Sweet to Babies During Painful Procedures video.
Next Meeting / June 9, 2016
Heather will be the minute taker
Evelyn will be back up minute taker