Healthiest Babies Possible (HBP) has provided a pre and postnatal outreach program in Surrey, Delta and White Rock since 1988. In 2016/17, the HBP program provided perinatal education and support to 505 participants, with 90% experiencing low income and 42% new immigrants or refugees.

One-on-one support from Pregnancy Support Workers or Registered Dietician are offered to women who are 28 weeks pregnant, or earlier and encountering certain risk factors.  These and other women are invited to the average of 9-10 groups held per month in 3 neighbourhoods, offering women and their families an opportunity to learn, have a nutritious meal, and meet other families.  The groups in Guildford, North Delta and Newton offer education and support in English (with as-needed interpretation support) and the Newton South Asian Group offers information and support in Punjabi.  On-site child care is provided for some groups and bus tickets are available to assist with transportation.  Participants are welcome to attend groups throughout pregnancy and until their baby is 6 months old.

The range of drop-in groups offered by HBP includes a Lunch Club, Pre/Postnatal Yoga, the South Asian Group, a Community Kitchen, and a Breastfeeding Café.  We spoke with Carol Dyck, a public health nurse and lactation consultant with Fraser Health, who has developed the program along with Jen Mantyka, the Program Director for HBP.

Studies have demonstrated that at least 1:4 children (US CDC, 2014) have experienced child neglect or abuse (including physical, emotional and sexual) at some point in their lives.  Given that child abuse and neglect affect children’s health both now and later, the value of developing strong, affirmative bonding between parent and child from birth is crucial.  “Breastfeeding is a natural safety net against the worst effects of poverty….exclusive breastfeeding goes a long way towards cancelling out the health difference between being born into poverty or being born into affluence.” (James P. Grant, Executive Director of UNICEF, 1980-1995).  More recently, with ever-increasing attention being paid to the ACES study (US CDC) and the impact of toxic stress on the child, the potential role of breastfeeding as a mitigating factor to buffer the effect of this toxic stress is also being explored.  http://www.nursingoutlook.org/article/S0029-6554(16)30125-7/abstract

In 2016, the Surrey BFI Committee held a community meeting, hosted by HBP; there was a literature review completed on breastfeeding support models with Langara nursing students and their instructor, Gayle Allison; and Fraser Health PPH Renewal held discussions on changes to delivery of services, including breastfeeding support.  These initiatives then led, in 2017 to a discussion with Jen Mantyka about the possibility of setting up a pilot project trialing a Breastfeeding Café at HBP.

The first Baby Café was started in the UK in 2000, followed by the first US Baby Café in 2006.  There is a non-profit organization supporting the development of licensed Baby Cafes, which sets standards and  requires application and start-up fees, along with annual renewal fees, to be licensed as a Baby Café. Whilst there is no similar overseeing agency in Canada, using the term Baby Café without licensing, could involve copyright infringement, so a different name was chosen.  There are some other existing breastfeeding cafes in Canada, including South Surrey/White Rock, Kelowna, Prince George, and Saskatoon, however these are geared more for the general population of breastfeeding families.

In setting up the Breastfeeding Café, an advertising promotion was done to weekly lunch clubs and the HBP Facebook page; to community agencies such as the local health unit, La Leche League, community midwives, and others; and through referrals from Pregnancy Support workers.

The aim was to create a space that is relaxing and safe, builds in social support, offers incentives such as bus tickets, and to which partners and other supporters are welcome to attend. The Café offers opportunity to ask questions and share breastfeeding experiences, access information sessions on breastfeeding topics, receive 1-1 support from a lactation consultant and/or breastfeeding counsellor.

The first HBP Breastfeeding Café opened in August 2017 at the Newton Early Years Centre. 9 sessions were held in 2017 with the pilot group that involved 12 women (7 pregnant, 5 breastfeeding).  The facilitators are developing customized materials to use with the group and to overcome language barriers.

The café is held twice monthly, with bus tickets and other incentives, such as free breast pads and milk storage bags, to encourage attendance.  As the group is still becoming established, and numbers are small at this point, it is possible to offer lots of individualized breastfeeding support.  Prenatal mums have also been invited to attend in order to get a better idea of what the experience of breastfeeding is like for others.

The café is specifically targeted for the selective population group who meet the CPNP criteria.  It is well known that this group tends to have much lower breastfeeding rates than other populations.  Cultural issues in the communities in which many of the women accessing CPNP programming belong, mean that women are often resistant to breastfeeding in public, or even in their homes, except in their bedrooms, especially if they are living in a multi-generational household.  These pressures, along with a sense of isolation, tend to lead to women stopping breastfeeding quite quickly.  Many of these women also experience significant barriers to accessing additional support and health care in general.

The response from mothers who have attended the café so far is that they are glad for the information that is provided, appreciate having their babies weighed, and are grateful for the personalized support for breastfeeding.

As numbers increase, it is hoped that a peer-support model can be developed, but the program is only sustainable if numbers grow.  Carol and Jen would appreciate the opportunity to connect with CPNP programs that are trying something along similar lines, to share ideas and suggestions for how they might be able to grow and develop the program.  Contact:  Jen Mantyka  jen.mantyka@options.bc.ca