National Collaborating Centre for Methods and Tools

At different conferences and outreach events NCCMT has attended in the past few months, many network members have been discussing the process of implementing breastfeeding best practice guidelines across their health unit or regional health authority. We’ve also heard of the growing interest for organizations to adopt the Baby Friendly Initiative (BFI) and to seek BFI accreditation.

Are you currently trying to roll out breastfeeding guidelines across your organization? Have you already had success in doing so? What methods or tools did you use to help implement these guidelines? What changes needed to occur in your organization to adopt these guidelines?

Feel free to use this discussion topic to post questions, share resources and your experiences of how your organization implemented breastfeeding best practice guidelines.

Although many of us can understand the benefits of seeking BFI accreditation or adopting a breastfeeding best practice guideline in our organization, I have heard from many public health practitioners from across the country that the process seems quite daunting to them and they don't know where to start. There are many individual and organizational barriers to change that they are facing. For example, just one of the many things we'd need to consider is: do we need to change what nurses in our organization are teaching in prenatal and/or parenting classes and home visits related to breasfeeding or formula feeding and the key messages they are providing?

Public health professionals often work with many stakeholders and community groups in external settings as well as working in their own organization. As a result it can be difficult to implement a best practice guideline. Does any have experience with this? There is probably a lot we can learn from each other. What has worked and what hasn't? Why or why not?

I recently learned that the Thunder Bay District Health Unit (TBDHU) was the first community health service in Ontario to receive the designation of a "Baby-Friendly Community Health Service" (2006).

Since then, I have had a conversation with Laura Prodanyk, a Public Health Nurse from the Thunder Bay District health Unit about the process of becoming BFI accredited in 2006 and re-accredited in 2011. Laura has agreed to share the details of how her health unit implemented the BFI practice guidelines.

I will be posting our conversation to this thread over the coming week. If you have questions/comments, please log-in and join the conversation!

Kirsten

What was the impetus for first seeking BFI accreditation at TBDHU in 2002?

[Laura Prodanyk]

TBDHU received provincial funding in 2001 to work on a project that was outside of the public health department’s current mandate. At the time, BFI accreditation was ‘over and above’ the health unit’s mandate. There was internal support in the health unit to pursue Baby Friendly Initiative (BFI) accreditation.

Was there a champion from within TBDHU supporting this initiative?

[Laura Prodanyk]

The Medical Officer of Health at the time, David Williams, was very supportive of this initiative. One of our lactation consultants from the Healthy Baby Healthy Children (HBHC) program, was a member of a local breastfeeding coalition and acted as an internal champion. She and the manager of HBHC presented a proposal to pursue BFI accreditation to the health unit’s Board of Health and received positive support. Getting leadership support for this initiative was not a barrier at TBDHU. When the time came for designation in 2006 and re-designation in 2011, there were additional champions.

What steps were taken to get TBDHU ready to be assessed?

[Laura Prodanyk]

We followed the Breastfeeding Committee for Canada’s (BCC) “The Baby-Friendly Initiative in Community Health Services: A Canadian Implementation Guide" and the BCC's “The Seven Point Plan and Practice Outcome Indicators for the protection, promotion and support of breastfeeding in Community Health Services” (October 14, 2003).

The process included:

- Establishing a multidisciplinary breastfeeding committee
- Self-appraisal process
- BFI pre-assessment
- Prepare for BFI external assessment
- Maintain BFI status

As a result of completing a pre-assessment, did TBDHU have to change any of its existing practices or key messages being used with its prenatal clients?

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