Transcript BFCI - New Zealand Breastfeeding Authority: Home Page

BFCI
The Seven Point Plan
Point One:
Have a written breastfeeding policy
that is routinely communicated to all
staff and volunteers
The Policy:
 What should it cover?
At minimum it should include:
- The 7 Point Plan
- Compliance to the International Code of
Marketing of Breast-milk Substitutes
- Reflect the guiding principles of the BFCI
Implementation Guide for Health Services
Point One: The Policy
 Consultation
-
Must be shown by documentation
Treaty of Waitangi included/intertwined
Extensive consultation evidenced!
Sign-off date noted
Displayed in all areas
Different languages
Education about policy for all staff and volunteers
Other policies to support policy eg: Staff employment
policy.
- Measured effectiveness of the policy
Point 2:
 Train all providers in the knowledge
and skills necessary to implement the
breastfeeding policy.
“ If you think
education is expensive,
try ignorance”
Areas of knowledge
 Guiding principles of The Seven Point Plan
 Content of The Seven Point Plan
 Basic information on breastfeeding support
and management
 Skill development related to breastfeeding
support and management
 Attitudes and barriers to breastfeeding
 Community resources for breastfeeding
 Staff educated to the level of their role
 Policy orientation on commencing work
 New staff – education available within
6months
Required Education:
 Specialist Staff (working with mothers)
At the time of assessment 80% need to
have completed the minimum of 21 hours as
stipulated in the standards for Step Two (this
includes information from pregnancy through to
complementary foods)
Demonstrates appropriate clinical skills
Continuing education equates to 4 hours
annually
Some Groups/individuals may choose to
refer to a Lactation Consultant or other
breastfeeding advisor.
They need to show:
Evidence of referral system
Equates to 2 hours education for each
year of employment (assessed for the
previous 3 years)
Continuing education equates to 2
hours annually
 All other staff:
Equates to one hour for each
year of employment – assessed
over the previous 3 years
ongoing education equates to 1
hour annually
Point Three:
 Inform all pregnant women and their
families about the benefits
and management of
breastfeeding.
Antenatal Education should include:
 Importance of breastfeeding
 Importance of exclusive breastfeeding until 6
months
 Importance of feeding at the breast
 Health consequences of artificial feeding
 Risks and costs of artificial baby milks
 Contraception (compatible with breastfeeding)
 The Ten Steps to Successful Breastfeeding
 Support in the work place during pregnancy and
breastfeeding
 The challenge of re-lactation
The Service must also…….
 Recognize the importance of educating the
woman who has decided to, or needs to,
feed her baby artificial baby milk.
Point Four
 Support mothers to establish and
maintain exclusive breastfeeding to six
months
How?
 Good antenatal education +
 Good establishment of breastfeeding +
 Good breastfeeding support
Examples……
 Antenatally:
Realistic breastfeeding expectations
Personal expectations
Social preparation
Knowledge of support systems available
……establishment
 Aware of the importance of exclusivity of
feeding at the breast
 Knowledge of breastfeeding management
 Frequent contact for assessment of
progress
 Early identification of any breastfeeding
‘hiccoughs’
 Awareness of safe and unsafe sleep
practices
……….support
 Aware of how to access assistance at any
time over the 24 hours of a day if
necessary!
 Encouragement to attend peer
breastfeeding groups
 Given appropriate information about
maintenance of lactation if separation
necessary
 Offered timely advice about contraception,
compatible with breastfeeding
Mothers Not Breastfeeding
 Given individual (including partner/family as
necessary) support and education covering:
Safe preparation and handling of formula
Sterilization of equipment
Safe feeding techniques
Discussion about co-sleeping
Point Five
 Encourage sustained breastfeeding
beyond six months, to two years or
more, alongside the introduction of
appropriate, adequate and safe
complementary foods
Principles:
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Maintain breastfeeding
Practice responsive feeding
Prepare, store complementary food safely
Increase amount gradually while
breastfeeding
 Ensure consistency of food appropriate to
age
 Adapt meal frequency/density to age
cont’d…….
Cont’d……..
 Ensure nutrient content of foods meets
infants needs
 Use fortified products if needed
 Adapt feeding during/after illness
 Information offered concerning
breastfeeding in the workplace
 Information available about contraception
and co-sleeping
Sustain breastfeeding until natural weaning
occurs – don’t offer to breastfeed – but don’t
refuse!
Point Six
 Provide a welcoming atmosphere for
breastfeeding families
How?
 Welcome to breastfeed in public areas of
the service
 Private space available if requested – clean,
quiet with a comfortable chair
 Educate staff about mothers right to
breastfeed
 Notices displayed stating mothers are
welcome to breastfeed – posted in
appropriate languages of the service…….
Continued……….
 Culturally appropriate area and information
 Evidence of consultation with each mother
to ascertain their needs can be seen
 Feedback/suggestions opportunity for
mothers
 “Code” compliant handouts and information
available to take home
 Services which do not work from a site
need to meet these requirements
whenever they deliver the service for example – a Lactation Consultant
visiting a woman in her home needs to
have an evaluation form (assessment
of presenting condition) and a feedback
form for the mother
Point Seven
 Promote collaboration among health
services and between health services
and the local community
Wow! This is great!!!
 Requires involvement of entities outside
the service – the service will:
Avail themselves to any opportunity to
collaborate with others
Community consultation with Policies
Have strong systems in place at the
interface …. hospitals, LMC’s, Plunket etc
Use written referrals which contain
information about B/f status & B/f issues
Services need to work together…
 To support the breastfeeding dyad
Share information
Have discussions
Give feedback
……this ensures continued support
Breastfeeding Resources….
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Mother – to – mother
Parent support
Lactation Consultants
Breastfeeding Clinics
Maori Health Agencies
Pacific Health Agencies
Practice nurses ……………
….and there’s more …..
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Midwives
Doctors
Nutritionists
Pharmacists
Dental services
Health promoters
 Antenatally…….
Refer women to voluntary groups
Assist them to set up own informal
support networks
 The service can show commitment to
the BFCI by…….
Supporting World Breastfeeding Week
Letters to the editor
Supporting breastfeeding campaigns
Identifying and overcoming
breastfeeding barriers within the
community
Working together
References:
 BFCI Documents for Aotearoa New Zealand
 BFHI 2004, Baby-Friendly goals expand to
community and pre-service training. Baby Friendly
and beyond - Integrated care for mother and child
2: 1.
 UNICEF UK Baby Friendly Initiative 2008, The
seven point plan for sustaining breastfeeding in the
community.
 IYCF Model Chapter for textbooks for Medical
Students,(2009) Session 4 & 5