The Board of Health:

1.          urged all Toronto birthing hospitals to achieve Baby-Friendly designation as soon as possible, giving priority to:

a.         developing a written policy that covers all Ten Steps to Successful Breastfeeding, including a mechanism to evaluate the policy;

b.         helping mothers initiate breastfeeding within a half hour of birth;

c.         ensuring that newborn infants are not given food or drink other than breast milk unless medically indicated; and

d.         refraining from the practice of providing infant formula to mothers at hospital discharge;

2.          requested the Medical Officer of Health to:

a.         work in collaboration with Toronto birthing hospitals to support their efforts to achieve Baby-Friendly designation and re-assess compliance with the Ten Steps to Successful Breastfeeding; providing a progress report to the Board of Health in two years;

b.         ensure that Toronto Public Health achieve Baby-Friendly designation and provide a progress report to the Board of Health in two years;

c.         continue to work with key stakeholders to promote exclusive breastfeeding to six months of age using population-wide and targeted strategies, paying particular attention to those women less likely to exclusively breastfeed to six months (i.e. younger women, recent immigrants, women with lower levels of income, women having a Caesarean birth);

d.         continue to work with key stakeholders to develop and implement strategies to engage public facilities (e.g. malls, restaurants, recreational facilities, parks, schools, colleges and universities and the workplace) in breastfeeding friendly initiatives, thereby increasing the number of breastfeeding friendly places and supporting a woman’s right to breastfeed in public;

e.         continue to work with key stakeholders to maintain high rates of breastfeeding intention and initiation, paying particular attention to those women who are less likely to plan to breastfeed or initiate breastfeeding (e.g. younger women, women with low levels of education and women with lower levels of family income);

f.          report annually to the Board of Health on birthing hospitals in Toronto which have achieved the “Baby-Friendly Designation”;

g.         report to the Board of Health in 2011 on the success of birthing hospitals in achieving the four priority recommendations; and

h.         advise Toronto BIA offices and the Toronto Association of Business Improvement Areas (TABIA) on the Breast Feeding Friendly Campaign and to ask for assistance in getting businesses to be breastfeeding friendly and post the sticker;

3.         requested the Medical Officer of Health to forward this report to the Ontario Minister of Health and Long-Term Care and the Better Outcomes Registry & Network (BORN) Ontario, acknowledging the Ministry's progress toward the development of an integrated perinatal data collection system and requesting that the Minister ensure that the Niday Perinatal database is collecting:

a.         accurate and complete infant feeding data to enable hospitals and community health services to monitor rates of initiation and any and exclusive breastfeeding; and

b.         key sociodemographic and sociocultural indicators to enable the identification of subpopulations at risk for low breastfeeding rates and adverse maternal/infant health outcomes;

4.         urged the Minister of Health and Long-Term Care to forbid birthing hospitals from accepting free donations of formula or other inducements in compliance with the WHO International Code of Marketing of Breastmilk Substitutes;

5.          congratulated the Toronto East General Hospital for meeting all the requirements supporting breastfeeding, and obtaining the Baby-Friendly Designation; and

6.         forwarded this report to the Ministry of Health Promotion, the Ministry of Health and Long-Term Care, the Ministry of Children and Youth Services, the Provincial Maternal Newborn Advisory Committee, the Ontario Public Health Association, the Ontario Breastfeeding Committee, the Child Health Integration Network of the Greater Toronto Area, the Local Health Integration Networks that are responsible for Toronto birthing hospitals and Toronto Best Start Network.

The following gave a presentation to the Board of Health on "Breastfeeding in Toronto, Promoting Supportive Environments":

-           Dr. David McKeown, Medical Officer of Health;

-           Lydia Ling, International Certified Lactation Consultant; and

-           So-Yan Seto, Acting Manager, Healthy Families, Toronto Public Health.

The Chair of the Board of Health and the Medical Officer of Health presented a scroll from the Quintessence Foundation to Lydia Ling and So-Yan Seto congratulating Toronto Public Health and the Chinese/Vietnamese Breastfeeding Network on having the largest number of participants at a Quintessence Breastfeeding Challenge 2009 event they organized in Toronto.

 The Board of Health:

1.         wrote to the Premier of Ontario offering support for the Plan identified in the “With Our Best Future in Mind: Implementing Early Learning in Ontario” report, and calling on the Province to endorse the full plan and to ensure that:

a.         Boards of Health remain responsible for delivery of the Healthy Babies, Healthy Children (HBHC) program;

b.         Boards of Health receive sufficient and sustainable funding to support a full range of Reproductive Health and Child Health services in the Best Start Child & Family Centres (BSC&FC), including Healthy Babies, Healthy Children, Preschool Speech and Language, and Infant Hearing;

2.         requested the Medical Officer of Health to collaborate with Toronto Children’s Services (the Consolidated Municipal Service Manager) to seek opportunities to integrate appropriate early childhood public health program activities into child and family centres where feasible;

3.         requested the Province of Ontario to apply the provision of the Day Nurseries Act related to key public health priorities (e.g. provision of food and infection control) to the Early Learning and Childcare program;

4.         petitioned the provincial government to implement a monitoring and evaluation program to assess the health impact on children as they proceed through the program, as well as ensure that implementation of the program does not result in reduced childcare capacity in the City of Toronto;

5.         wrote to the Assistant Deputy Minister, Early Learning Division, Ontario Ministry of Education, to express support for the overall vision of the Early Learning Plan, including the establishment of Best Start Child and Family Centres, to identify potential implications for public health funding, service delivery, planning and accountability and to offer support in working with the Ministry to effectively address these implications; and

6.         sent this report to the Minister of Children and Youth Services, the Minister of Education, the Minister of Health and Long-Term Care, the Minister of Health Promotion, the General Manager of Toronto Children’s Services Division, the Ontario Public Health Association, the Association of Local Public Health Agencies (alpha), the Assistant Deputy Minister, Early Learning Division, Ministry of Education and the Toronto Best Start Network.

In June 2009, Dr Charles Pascal, the Special Advisor on Early Learning, presented his report “With Our Best Future in Mind:  Implementing Early Learning in Ontario”, to the Premier.  This report offers a bold vision for the transformation of early learning, extended child care, and family supports in Ontario.  Based on solid evidence and best practice, this vision for Ontario’s and Toronto’s young children and families offers significant potential for improving family access to service and optimizing developmental outcomes for children.

The Early Learning Plan proposed in the report includes a number of recommendations that have implications for public health funding, service, and accountability.  It is consistent with the goals of the Reproductive Health and Child Health requirements of the Ontario Public Health Standards and offers public health a new means of reaching out to pregnant women, young children and families.  Consequently it is recommended that the Board of Health support the overall vision of the Plan.

The provincial government has endorsed the full day learning and extended child care components of the Plan.  There is, however, less clarity about the Province’s commitment to the broader vision.

This report provides a general description of the implications of the Early Learning Report for public health services, and identifies those recommendations that the public health community and Toronto Public Health supports and those that may be of concern and/or require further clarity.  This report also describes provincial and local activities that ensure that public health is at the Early Years planning tables.

Local Health Committees submitting the following:

-           Minutes of the Etobicoke/York Local Health Committee meeting held on June 11, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on October 15, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on November 12, 2009.

-           Minutes of the Etobicoke/York Local Health Committee meeting held on January 14, 2010.

-           Minutes of the North York Local Health Committee meeting held on January 14, 2010.