Item - 2020.HL20.6

The Board of Health:

1.  Received the report (September 3, 2020) from the Medical Officer of Health for information.

The Baby-Friendly Initiative (BFI) is an internationally-recognized designation that was started in 1991 by the World Health Organization and the United Nations Children's Fund (UNICEF) to encourage practices that protect, promote, and support breastfeeding. In 2013 and 2018, Toronto Public Health was granted BFI designation by the Breastfeeding Committee for Canada. Designation can be obtained every five years by successfully completing a rigourous, multifaceted process.

In addition, since 2019 Toronto Public Health has implemented the Registered Nurses' Association of Ontario's Breastfeeding Best Practice Guidelines (BPGs) entitled: Breastfeeding - Promoting and Supporting the Initiation, Exclusivity, and Continuation of Breastfeeding for Newborns, Infants, and Young Children (2018). The BPGs offer 16 evidence-based breastfeeding education and promotion recommendations that incorporate all BFI principles.

The 2008 Ontario Public Health Standards made BFI designation a performance indicator for public health units. However, this indicator was removed in the Standards' 2018 update. Obtaining BFI designation was initially beneficial to develop practices to support breastfeeding. Given that obtaining BFI designation is a recurring resource-intensive endeavour, and now that strong practices have been established, Toronto Public Health will maintain its BFI designation until 2023 and, thereafter, continue to implement the BPGs' recommendations.