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Breastfeeding Supports and Services Work Group
Breastfeeding
The World Health Organization (WHO) and Health Canada recommend that infants be exclusively breastfed for the first 6 months of life as breast milk is the best option for optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond.
Breastfeeding benefits have been well documented and demonstrate significant health and psychosocial outcomes for both infant and mother. Health Canada advises that breastfeeding provides the best nutritional, immunological and emotional benefits for the growth and development of infants.1 According to WHO, breastfeeding is one of the most effective interventions to improve child health and long-term survival. 2 Breastfeeding is associated with a significant reduction in the incidence of several illnesses in infancy, childhood and later life.3,4,5,6 Studies also show that breastfeeding facilitates the mother/infant bonding process,7,8,9 improves children's cognitive development 10 and may have a protective effect on child and adolescent mental health.11 Breastfeeding also has positive effects on the physical health of mothers.12,13,14,15,16
International studies show a significant association between the lack of breastfeeding and substantial costs to the health care system; it can be surmised that the results have applicability to Ontario’s health care system.17,18,19
PCMCH Breastfeeding Services and Supports Work Group
In 2009, the Ministry of Health and Long-Term Care requested that the Provincial Council for Maternal and Child Health establish an expert panel (the Breastfeeding Services and Supports Work Group) tasked with providing cost-effective recommendations and options to support the delivery of breastfeeding supports and services in Ontario with a focus on improving breastfeeding initiation, duration and exclusivity rates. The Work Group, consisting of breastfeeding experts from across the province and a variety of disciplines, commenced their deliberations in November 2009.
The Breastfeeding Services and Supports Work Group’s recommendations have been approved by PCMCH. Recommendations were made pertaining to direct services provided within hospital and community-based organizations. Other recommendations related to system capacity, policy and evaluation were also made and are being reviewed at a system level.
Breastfeeding Recommendations
The recommendations regarding practice standards for direct services are outlined along with links to resources developed to help hospitals and community organizations in their efforts to achieve the recommendations. Many of the resources can be customized to fit the needs of a specific organization.
Click on the links below to access the following materials and resources:
3. Ip S, et al (2007). Breastfeeding and Maternal Health Outcomes in Developed Countries. AHRQ Publication No. 07-E007. Rockville, MD: Agency for Healthcare Research and Quality.
4. Quigley M, Kelly, Y, and Sacker, A. (2007). Breastfeeding and Hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study. Pediatrics, Vol. 119, No. 4, April 2007, pp. e837-e842.
5. Horta B et al (2007). Evidence on the long-term effects of breastfeeding. WHO.
9. Widstrom A, Wahlberg V, Matthiesen A, Eneroth P, Uvnas-Moberg K, Werner S &Winberg J (1990). Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Hum Dev, 21, 153-163.
14. Dewey et al. Effects of exclusive breastfeeding for four versus six months on maternal nutritional status and infant motor development: results of two randomized trials in Honduras. J Nutr 2001; 131:262-7.
15. Institute of Medicine Food and Nutrition Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc.2001. Retrieved from http://www.hc-sc.gc.ca/fn-an/nutrition/child-enfant/infant-nourisson/excl_bf_dur-dur_am_excl-eng.php
16. Kramer, M.S., Kakuma, R. The optimal duration of exclusive breastfeeding: A systematic review 2002. Retrieved from http://www.who.int/nutrition/publications/optimal_duration_of_exc_bfeeding_review_eng.pdf
17. Bartick, M. & Reinhold, A. (2010). The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pedatrics, 10.1542, 1048-1056.
18. Smith, J.P., Thompson, J.F., Ellwood, D. A., (2002). Hospital system costs of artificial infant feeding: Estimates for the Australian Capital Territory. Aust N Z J Public Health. 26, 543-51.
19 Cattaneo, A., Ronfani, L., Burmaz, T., Quintero-Romero, S., Macaluso, A & Simona Di, M. (2006). Infant feeding and cost of health care: A cohort study. Acta Pædiatrica, 95: 540-/546.
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