Healthy Living in the North

Healthy relationships through harm reduction

reanne and her son riding horses.I grew up in the North, and I feel blessed to be able to live and practice in my hometown of Quesnel. Guiding my work, I have two strong influences from my childhood: medicine and ranching. On my mother’s side I come from several generations of nurses and doctors; my father’s family were pioneers and moved to this community 100 years ago.

Growing up as a ranch kid helped me to develop a strong belief that all living things have value and worth. This has helped me to recognize that our own advancement and success is based on how we honour relationships in our lives, and for me growing up, these were family and cattle.

When I was asked to write an article about my work in harm reduction and how it relates to healthy relationships, I had to sit with it for several days. Before my current role, I worked as a generalist public health nurse for 13 years, and part of my role was as the local street nurse, but for some reason, in my mind, I couldn’t get the two to connect. The more I thought about it though, the more I began to realize the reason for my difficulty was that these two concepts are inseparable. From my experience, it would be extremely difficult to apply the principles of harm reduction within health care without considering the importance of healthy, trusting relationships.

Harm reduction involving drugs and people who use drugs is a social justice movement that strives to uphold basic human rights. It means believing in, respecting, and supporting people who use drugs, whether abstinence is their goal or not. This kind of harm reduction is supported by evidence based research, and proven to be effective in reducing risks and ultimately reducing the burden on the health care system.

A good example of this method of harm reduction is the distribution of harm reduction supplies to people who use drugs. Providing clean, sterile equipment has also shown to reduce new infections of HIV and Hepatitis C within our communities.

Healthy Relationships

Another benefit of distributing harm reduction supplies to clients, is the opportunity for service providers to develop meaningful relationships with the client; these relationships can ultimately lead to greater access to health care. We know that when people engage in services where they feel supported and accepted by staff, they are more likely to make positive changes and further access supports.

Relationship building is at the core of harm reduction work. When you show up for people and allow them to be seen and heard, they feel valued and worthy. This is so important within a demographic of individuals who often feel marginalized and ostracized in our communities.

This is a mutually beneficial relationship, as we, the service provider, can ask clients questions in order to gain a greater understanding of the barriers and challenges they face, and better understand the world they live in. This connection allows staff to hear real, lived experiences that can ultimately help them implement change.

The caring bonds and healthy connections created through harm reduction is lifesaving for clients. Over the past few years, the landscape of working with people who use drugs has changed drastically. In the past, we worried about keeping people safe, preventing HIV transmission, and other harms related to drug use; now, we’re worrying about keeping people alive.

In order for clients to engage in our services, receive education on how to safely use drugs, take harm reduction steps towards wellness, and to enter into treatment (if that is what they choose), they must be with us. It is well known that the number of people dying across the province due to unintentional illicit drug overdoses has continued to rise in 2017, despite exceptional work on the frontlines.

Reducing Stigma and Judgment

In today’s society, it’s important to use a thoughtful approach and be compassionate with our messaging. Stigma and judgment towards people who use drugs creates a climate where people do not feel safe to share experiences, and in turn, forces them to isolate themselves. Working closely with harm reduction has shown me how vast and diverse this population is in our communities.

Reducing stigma and judgment in our communities takes a collaborative approach. Northern Health has championed anti-stigma work in B.C. as a part of our overdose prevention strategy. You can make a difference by changing the conversation:

  • Describe peers as individuals (i.e. “person with a substance use disorder” vs “drug user”).
  • Decide not to share or engage in fear-based messaging about overdoses and drug use on social media.
  • Be mindful of how you talk about people who use drugs; choose not to use discriminating language like “user,” “junkie,” or “addict.”

These small steps can work to help eliminate the feelings of isolation and judgment.

Harm reduction in the context of substance use is about advocacy and caring. It is understanding that people use drugs for a variety of reasons, and many will never become dependent or deal with an addiction. Above all, harm reduction services exist to support everyone in staying as safe and healthy as possible – and that’s what we’re all after: staying safe, healthy, and happy. Together.

About Reanne Sanford

Reanne is the Regional Nursing Lead for Harm Reduction, and is based in Quesnel.

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World AIDS Day 2018: Know your status

A hand holding a small red AIDS ribbon.I distinctly remember learning about HIV and AIDS back in 1992 during my grade 7 Family Life class (no need to do the math to calculate how old that makes me!). AIDS was absolutely terrifying to this naïve 12 year old. I clearly recall a few things:

  1. HIV could not be transmitted through every day contact like a handshake, hug, or even from using the same toilet seat.
  2. HIV was transmitted through direct contact with bodily fluids, such as through unprotected sex or the use of intravenous drugs.
  3. HIV turned into AIDS, which then led to illness and certain death.

Since taking on my new role, which focuses heavily on HIV, I’ve been brushing up on the facts related to HIV and AIDS. I’m really proud of my teacher for clearly articulating that HIV isn’t easily transmitted. I think that having this understanding prevented me from being unnecessarily afraid of people living with HIV. She also taught the importance of protected sex and not sharing needles, which is still absolutely key in preventing the spread of HIV. However, some things have changed and it’s super exciting!

The facts about HIV

Advances in testing and treatment have transformed the prognosis for people living with HIV. Did you know that:

  • HIV is now considered a chronic illness?
  • Treatment, for some, can consist of only one pill per day?
  • People can live their entire lives with HIV and not ever develop AIDS?
  • A person with HIV has every chance now to live almost as long as someone who does not carry the virus?

However, these facts are only true for people who are aware of their HIV status and are actively participating in treatment.

Know your status

The theme of this year’s World AIDS Day is “Know Your Status,” encouraging all of us to know our HIV status. The latest UNAIDS Report shows that between 10-20% of people do not know they are infected with HIV. If a person isn’t aware that they have HIV, they will not be receiving the treatment that they need to allow them to live a long, healthy life and they may not be taking the necessary precautions to prevent the transmission of the virus to others. Alternately, once a person knows they have HIV, they can access treatment and psychosocial supports to suppress the virus in their body and employ the necessary measures to avoid passing HIV on to their loved ones.

When was the last time you were tested for HIV?

I was tested last year as part of prenatal screening to ensure that, had I been infected, transmission to my baby could be avoided. My mom was tested this year because her doctor offers testing to everyone between 18-70 years of age, at least every 5 years. My good friend recently asked to be tested before beginning a sexual relationship with a new partner.

It’s up to each of us to take responsibility for our health, and the health of our communities, by knowing our own HIV status. If you haven’t been tested recently, what are you waiting for? It’s a simple blood test that can make a world of difference. To get tested, ask your physician or nurse practitioner to order the lab work for you. For other ways to access HIV testing, or to learn more about the virus and how it can be transmitted, visit www.hiv101.ca.

I’m amazed at how far HIV research has come since those days of grade 7 Family Life. However, we still have a long way to go in reducing the stigma associated with HIV and eradicating the virus all together, and the first step is normalizing getting tested for HIV.

My son will be 12 in 2030, which is likely when he will take Family Life like I did. My hope is, by that point in time, there won’t be a module on HIV and AIDS because the ongoing progress on prevention and treatment will have been successful in completely eradicating the virus.

Ashley Stoppler

About Ashley Stoppler

Born and raised in Prince George, Ashley is a two-time UNBC graduate. She has worked for Northern Health since 2004 and has held nine positions across the spectrum of health care, ranging from Maternity to Long Term Care, and many areas in between. She’s recently moved into a strategic position with the Regional Chronic Diseases Program, focusing on HIV, Hepatitis C, Chronic Pain and Arthritis. Ashley is active in her community, sitting on the board on the YMCA of Northern BC and teaching yoga in her “spare time.” She also likes to channel her inner Martha Stewart at the sewing machine and in the kitchen, but what brings her the most joy in life is the time she gets to spend adventuring with her fiancé, infant son, and toddler dog.

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Food Security, Part 2: Food Costing in BC

How much does it cost for you to put food on your table? Your weekly grocery bill may come to mind, as well as how and where you get your food. But do you also factor in costs like getting to the grocery store?

The cost of a basic, healthy dietFood costing report cover.

The BC Centre for Disease Control’s latest food costing report was just released. This report shows how much food costs, as well as how much money is required to purchase a basic, healthy diet. The new report shows that:

  • Food costs have been rising across BC.
  • In northern BC, the average price of a basic, healthy diet is the highest it’s ever been: $1038 per month (for a reference family of four).

Food costs: only part of the story in the north

The true cost of eating, however, involves more than just food prices.

To learn more, I spoke with two community advocates: Stacey Tyers, from Terrace, and Liza Haldane, from Laxgalts’ap, in the Nisga’a valley.

Stacey points out that families in many small northern communities are faced with extra expenses because of long distances to grocery stores. This is the case in Laxgalts’ap, where travel to grocery stores can profoundly impact cost of food.

“Laxgalts’ap is over 300km round trip from the nearest grocery store, so cost of gas is significant,” says Liza. “That is, if you’re lucky enough to have a car.” Those who don’t have a vehicle must pay for a ride, and it can cost up to $200 return – on top of the grocery bill.

The north is also more vulnerable to bad weather and power outages, which can cause food losses.

“Imagine stocking your freezer full of food for the winter, and losing it all when the power goes out,” says Stacey. For many, this would be devastating.

Additional barriers to food access

Other barriers to food access exist for northern families:

  • Food travels long distances to reach northern stores – this can impact food quality and quantity.
  • Bad weather and road closures can affect food access and availability.
  • Shorter growing seasons limit the availability of locally grown foods.
  • Hunting, fishing, trapping, and gathering wild foods requires access to land, time, equipment, fuel, and specialized skills.

Access to nutritious cultural foods can be challenging as well, such as fish.

“If you don’t have a boat or money for equipment, it can be hard to access this resource. There are also new limitations on food fishing,” Liza points out. As a result, she feels that “access to food [has become] a privilege… It’s very alarming.”

Rising food costs in BC: those who are hardest hit

In an earlier story, I raised the topic of household food insecurity (HFI), which is when a household worries about, or does not have enough, money to purchase food. HFI and income are closely linked, so increases in food costs have the biggest impact on fixed and low-income households. According to Stacey, “those who have low incomes will be the hardest hit by rising food prices.”

Households who are on a fixed income (e.g. social assistance) and those earning minimum wage spend significantly more of their budget on food compared to median wage earners. And this amount does not include travel to grocery stores. With food costs on the rise, and social assistance and minimum wage set below the living wage, limited food budgets grow even tighter.

Next steps for BC

Northerners are resilient, but we experience additional costs, realities, and barriers to accessing food. HFI is a serious public health issue in the north. The Food Costing in BC report is one advocacy tool – what else is being done?

Stay tuned for my last story in this series, Food security: a call to action, to be released.

Laurel Burton

About Laurel Burton

Laurel works with Northern Health as a population health dietitian, with a focus on food security. She is a big proponent of taking a multi-dimensional approach to health and she is interested in the social determinants of health and how they affect overall well-being, both at the individual and population level. Laurel is a recent graduate of the UBC dietetics program, where she completed her internship with Northern Health. She has experience working with groups across the lifecycle within BC and internationally to support evidence-informed nutrition practice for the aim of optimizing health. When she is not working, Laurel enjoys cooking, hiking and travelling. She is looking forward to exploring more of the North!

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Supporting Conversation, Not Consumption

Cannabis is now legal for adults to use in Canada. No matter which side of this change you stand, the quest for knowledge, debate, and conversation about this subject is impressive. People are looking for accurate information to make informed choices, creating a great window of opportunity for individuals, families, organizations, schools, and communities to consider their substance use practices, policies, prevention strategies, and goals. It’s a great time to consider ways to promote and protect health from substance use harms.cannabis legalization banner

Public health experts across the country (including Northern Health’s medical health officers) support legalization and regulation of non-medical cannabis. While we recognize that there are risks attached to this, we believe there are ways to mitigate the risks and that the potential benefits outweigh the risks.

Some of the expected benefits to legalization through a public health approach include:

  • Decreased use of cannabis among youth.
  • Safer products with known potency.
  • Increased control over advertising and distribution.
  • Reduced stigma.
  • Reduced enforcement costs.

Some key points to know:

  • Cannabis is not a benign substance. The only way to be risk-free is not to use.
  • There are lower and higher risk ways to use cannabis.
  • Cannabis affects people differently, and individuals should consider their own situation before consuming.
  • Delay use as long as possible – youth are at increased risk to experience harm from cannabis.
  • You may be at increased risk if you are pregnant or breastfeeding, have personal or family history of psychosis or substance use problems.
  • If you are using cannabis and are in a higher risk bracket, you should consult your local health care team to consider your options for reducing potential harm.
  • Regular habitual use can cause psychological and physical dependence.
  • Cannabis impairs your ability to drive a car. Visit Don’t Drive High for more info.
  • Cannabis can be smoked, vaporized, applied to the skin, or ingested in food or drinks. Different methods of consumption carry different risks just like different potency and different products.
    • Smoking cannabis can harm your lungs – like smoking tobacco.
    • Ingesting cannabis through food has delayed response – so be aware and don’t take more thinking it hasn’t had an effect.
    • Edibles and topical are not legal in Canada at this time.
  • There remains a lot of unknowns with cannabis use and its effects.

More resources:

  • Get Cannabis Clarity – information on what’s legal, health information, safe communities, safe kids, safe roads, legislation.
  • Canadian Centre on Substance Use – information on youth substance prevention, health effects, and reports.
  • Here to Help BC – mental health and substance use information, screening tools, and self-help resources.
Stacie Weich

About Stacie Weich

Stacie Weich is the Regional Mental Wellness and Prevention of Substance Harms Lead for Northern Health’s Population Health team. A passion for people and wellness has driven her to pursue a career in mental health and substance use. The first 10 years of her career were spent at a non-profit in Quesnel. Shen then moved to Prince George to join Northern Health in 2008. Stacie has fulfilled many roles under the mental health and substance use umbrella since then (EPI, ED, NYTC, COAST, AADP, YCOS). In her off time Stacie enjoys spending time with her husband, two daughters, and two dogs, and other family and friends in beautiful northern BC!

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Canadian Patient Safety Week: Not all meds get along

Rob Pammett, Research and Development Pharmacist, holding a large bag of meds.

Rob Pammett, Research and Development Pharmacist – Primary Care, removing expired and unneeded medications from a patient’s home.

Canadian Patient Safety Week is October 29 – November 2, and this year’s theme is Not All Meds Get Along. It’s a reminder that modern medicine is very complex and requires careful monitoring to make sure people don’t experience medication-related harm.

Two thirds of Canadians over age 65 take at least five medications regularly, and more than 25% take over 10. We enjoy longer, healthier lives partly thanks to effective modern medications, but we should always be aware of the possibility of medication-related harm.

Medication interactions

Sometimes medications can interact with each other, making them work too well or not well enough, with serious consequences.

For example, imagine taking a natural health product that made your blood pressure medication work too well – you might start feeling woozy, low-energy, or even faint. This is a real example of what might happen if you took  peppermint extract and felodipine, a common blood pressure medication.

The importance of reviewing medications

Medication reviews help develop a clear list of your medications and how you’re taking them. A medication review can also help optimize your medications, making them easier to manage, safer and more effective. A review also gives both you and your healthcare team an up-to-date list of your medications, which can be vital if your health status changes, or if you need emergency care.

A wide variety of medications on the counter.Before starting any new medications (including over-the-counter products from a pharmacy, natural health products and vitamins, or even cannabis products), it’s important to talk to your pharmacist, doctor, or nurse practitioner. They can review your medications and give advice on whether they’ll be safe and effective for you.

Who should have a medication review?

I use the following 5 questions to help identify people who might benefit from a medication review:

  1. Do you regularly take 5 or more medications? (including prescription and non-prescription products, vitamins and minerals)
  2. Do you take 12 or more doses of medication each day?
  3. Are you currently taking medications for 3 or more medical conditions?
  4. Have your medications or the instructions on how to take them changed 4 or more times in the past year?
  5. Do you take any of the following medications?
    • Anti-epileptics
    • Anti-coagulants
    • Drugs for chronic pain
    • Insulin
    • Drugs to lower blood sugar
    • Lithium
    • Digoxin
    • Methotrexate

Answering “Yes” to 3 or more of these questions means there’s a good chance that your medications can be optimized: you should ask for a medication review. Stay healthy and have a great Canadian Patient Safety Week!

Rob Pammett

About Rob Pammett

Rob Pammett is the Research and Development Pharmacist – Primary Care, a partnership between Northern Health and the Faculty of Pharmaceutical Sciences at the University of British Columbia, where he holds the rank of Assistant Professor (Partner). He has an active clinical role in multiple primary care homes in Prince George and works with interprofessional teams to provide comprehensive care to patients.

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School Safety: The old and the new

Special Constable Fred Greene gives the facts about school safety in today’s world.

As I walked into the Prince George RCMP detachment to discuss school safety with Special Constable Fred Greene, I thought back to my school years. Was I safe back then? I think so. I knew to look both ways before I crossed the road, drugs and cigs were bad, and planning a safe ride home was a good thing. Pretty simple, right?

Well, to fall on that old cliché: “Times have changed.”

fred greene at a desk.It seems that each new generation of students has to deal with both the safety concerns of old (like crossing the road safely), and new safety hurdles that previous groups didn’t have to deal with. Technology has changed, social norms have changed, heck – even the climate has changed! Luckily, one thing hasn’t changed: the importance of teaching students about school safety and what they can do to be proactive.

That was why it was so great to sit down with S/Cst. Greene, an RCMP Community Safety Officer with more than 10 years’ experience. As someone who has presented hundreds of personal safety talks to student bodies ranging from elementary schools to universities, he was able to break down the big topics with me.

Here’s the big four, and what he had to say about each:

Pedestrian Safety

“Make eye contact and hand gestures with drivers before crossing street.”

Remember:

  • Use marked and signalled crosswalks, not shortcuts.
  • Wear light or reflective clothing at night.
  • Use sidewalks when provided, and walk facing the traffic if they’re unavailable.

drugs being exchangedDrug Awareness

“Plan ahead. As you make plans for the party or going out with friends, you need to plan ahead. You need to protect yourself and be smart. Don’t become a victim of someone else’s drug use. Make sure there’s someone you can call day or night, no matter what, if you need them. And, do the same for your friends.”

Remember:

  • First time use of street drugs can be fatal.
  • Usage and eventual addiction of prescription meds can be an easy way to get hooked on hard street drugs.
  • Consider that fentanyl may be found in street or non-prescribed medication.
  • Be cognizant that date rape drugs are easily attainable and can be found locally. They’re colourless, odourless, and easily placed in any drink.

Cyberbullying

“No information is truly private in the online world; an online ‘friend’ can forward any information posted on your site in a moment. Every text, conversation, photo, or phone call once sent will be permanent, public and searchable. If you delete a post, it can always be found.”

Remember:

  • Cyberbullying can be investigated under the Criminal Code as stalking, harassment, or threats.
  • If you receive bullying messages, don’t respond. Print them off and tell someone.
  • Anyone can pretend to be anyone, or anything, they want online.
  • Any inappropriate photos of someone under 18 years old on a device is considered child pornography.
  • Watch out for classified ads and inquiries from out of town or country. Be cautious of anyone asking for payment by Western Union or Crypto-currency.

Street Safety

“Stranger Danger. Don’t go with, take anything, or talk to a stranger. An adult never needs help from a child.”

Remember:

  • You are always safer in a group.
  • Use the buddy system when walking, attending events, or simply to talk to if you’re having a bad day.
  • Stay in well-lit areas at night and don’t use isolated trails.
  • Know your location at all times in case you need to reach someone or call 9-1-1.
  • Never meet a person from social media for the first time by yourself; meet in a public place with a friend or parent.

Interested in more safety tips? Visit these resources!

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Help your Community Health Star shine!

All over northern BC, in every community, there’s someone who’s pumping health and wellness back into their community. This could look like many different things: they’re raising awareness for mental illness; they’re supplying a healthy eating initiative to their town; they’re encouraging others to get up and be active; and who knows what else?!

Community Health Star Logo The best part? These folks are doing this for nothing other than to make the community they live in healthier and happier! At Northern Health, we call these people Community Health Stars (CHS), and we want to help them shine!

Each month, Northern Health would like to showcase a CHS, but we can’t find them without your help. When chosen, a CHS wins their choice of prize from Northern Health, and is highlighted through our social media channels plus the Northern Health Matters blog! Nominations will be accepted on an ongoing basis, so once a nomination is in, they’re eligible to win later as well!

Wondering what a Community Health Star looks like? Here are a couple examples of past Stars:

Peter Nielson – Quesnel, B.C.
Peter is a retiree who has always had a passion for helping seniors. He has created and supported several groups to address a wide range of issues impacting seniors. His message to others? “Check on your neighbours. If you know a senior, keep an eye on them.”

Myles Mattila – Prince George, B.C.
Myles works to promote youth mental health throughout the Prince George area and works with Mindcheck, a program that addresses mental health in a manner that is accessible for youth. It features a broad range of topics, including depression, mood, and anxiety issues; coping with stress, alcohol and substance misuse; body image, eating disorders, and more!

Hollie Blanchette – Valemount, B.C.
Hollie has served on 17 different community committees in Valemount, inspiring projects like Valemount Walks Around the World, the building of the Bigfoot community trail system, working towards a dementia-friendly community designation, looking into projects to keep seniors happy and healthy at home, coordinating a visiting hearing clinic, installing indoor/outdoor chess, and more!

So, who’s doing what around you? Do you know someone who’s helping others? Someone who betters your community? Nominate them as a Community Health Star!

Nomination takes almost no time at all, and you can help put the spotlight on someone who’s been doing something good for others and deserves to be recognized!

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Breastfeeding: It can look different!

(Co-authored with Randi Parsons, Regional Nursing Lead – Maternal, Infant, Child & Youth, and Lise Luppens, Population Health Dietitian)

Woman holding two babies with t-shirt that reads "sometimes breastfeeding looks like this."Tailor-made to meet the nutritional needs of her baby, a mother’s milk supplies unique immune factors, stem cells, hormones, and enzymes. The composition of her milk changes depending on the needs of her baby. How incredible is that!?

Breastfeeding is recommended where possible, as it supports:

Yet, in situations where feeding directly at the breast is not possible, many moms can continue to offer their milk to their babies.

  • To relieve full breasts
  • To collect breast milk if they will be away from babies for more than a few hours
  • To increase milk supply*
  • To maintain milk supply during times when feeding at the breast is not possible*
  • To collect milk for feeding via an alternative feeding method, such as a syringe, supplemental nursing system, cup, or bottle*

For families interested in providing expressed milk by bottle, it’s best to wait to introduce a bottle until breastfeeding is well established (usually after four to six weeks).

*Families who need to express breast milk, for reasons other than feeding by bottle, would likely benefit from the support of a lactation consultant, or other knowledgeable health professional or breastfeeding support person.

Helpful tips for families

Just like breastfeeding, expressing breast milk involves a learning curve for families. It’s helpful for families to receive support and information about:

Exclusive pumping and combination feeding

Some families make an informed decision not to feed at the breast. Instead, they express breast milk and feed this to their baby as their sole source of nutrition. This approach is sometimes referred to as “exclusive pumping.” Other families choose a different approach called “combination feeding,” where they alternate between feeding at the breast and feeding breast milk by bottle.

Regardless of the feeding approach, it’s vital for mother’s support systems, including friends, family, and health care providers, to have an awareness about milk expression, exclusive pumping, and combination feeding. This awareness ensures that mothers are well care for, and feel understood and supported.

The bottom line

There are reasons why a mother may not feed her baby at the breast. In these situations, we all have an important role to play in supporting women who wish to provide their own milk to their babies.

To learn more, consider these resources:

Theresa Healy

About Theresa Healy

Theresa is the regional manager for healthy community development with Northern Health’s population health team and is passionate about the capacity of individuals, families and communities across northern B.C. to be partners in health and wellness. As part of her own health and wellness plan, she has taken up running and, more recently, weight lifting. She is also a “new-bee” bee-keeper and a devoted new grandmother. Theresa is an avid historian, writer and researcher who also holds an adjunct appointment at UNBC that allows her to pursue her other passionate love - teaching.

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Tandem breastfeeding: Strengthening family connections

Young girl wearing a big sis t-shirt.

Expecting a second child can raise many questions, including how to breastfeed both of them at the same time, an approach called “tandem breastfeeding.”

Baby news! Our family is growing, and soon, we’ll be welcoming our second baby. This special news has our preschooler very excited – this is the same little girl, Jovie, who helped me to learn about the many joys (and challenges) of breastfeeding.

With our new bundle on the way, I’ve been wondering about breastfeeding both children, at the same time. This approach is called “tandem breastfeeding.” As a mom and a nurse, this topic fascinates me. Until recently, I knew very little about the topic, and today I’m sharing what I’ve learned so far.

Making an informed decision

Choosing to breastfeed is a personal decision, and breastfeeding looks different for every family. Some families consider the option of breastfeeding an older child during pregnancy, as well as after the arrival of a new baby. Here’s some information that might be helpful.

Is it safe?

  • In most pregnancies, it’s safe for women to continue breastfeeding an older child. La Leche League explains more in Nursing Through Pregnancy.
  • In some situations, caution may be advised.
  • Women can share their questions and concerns with their health care team.

Bonding time

  • Some mothers feel that breastfeeding during pregnancy can promote bonding with the older child as they prepare to be a “big sister” or “big brother.”
  • This definitely resonates for me as Jovie loves to “nuggle” more often lately. She wants to keep close to me and even talks (and sings) to baby – so cute!

…and then there were two (or more)!

  • When the new baby finally arrives, continuing to breastfeed an older child can help them to feel connected as their parents tend to the newborn’s unique needs.
  • Tandem breastfeeding also supports bonding between siblings. How special is that!?
  • An experienced nursling can also help their mother to manage breastfeeding challenges after the new baby arrives, such as engorgement, a plugged duct, or a forceful letdown.

Helpful tips to consider

It surprised me to learn so many interesting tidbits about tandem breastfeeding. I’ve also discovered that:

  • Pregnancy hormones may decrease the supply of breast milk. Jovie noticed this and announced “there’s no more milk, mama.” I assured her it would return, especially when the new baby arrives!
  • Mothers can feed both children at the same time, or feed each of them in turn. Families can do what works best for them.
  • Newborns should generally be breastfed first. Breast milk is their only food source, while older children are already enjoying a more varied diet.
  • Sharing the breast can be an adjustment for the older child. Engaging them in age-appropriate activities can help, as can trying different breastfeeding positions that allow mom to have a free hand. This sounds like juggling at its best! (HealthyFamilies BC shares some general tips about how to prepare an older child for a sibling).

Tick tock…

As we prepare for our newborn, I find myself feeling giddy about the new experiences we’re going to have as a family. There’s so much to learn, and I plan to consult my support circle as the pregnancy progresses. La Leche League has mother-to-mother support groups, so this would be a helpful place for me to ask about others’ experiences with tandem breastfeeding.

Interested in learning more, too? There are other resources to explore:

Randi Parsons

About Randi Parsons

Randi has lived in northern BC since 2010 after graduating from the University of Alberta with her Bachelor of Science in Nursing. Since her graduation, Randi has held different nursing positions with a focus in maternal-child health. Her career as a nurse started on Pediatrics in Prince George before transitioning into Public Health Nursing in the Omineca area. For 5 years, Randi worked as a generalist Public Health Nurse, finding her passion in perinatal wellness, early child development and community collaboration. With her husband, daughter and two Chihuahuas, Randi lives in Fraser Lake, currently working as the Regional Nursing Lead for Maternal, Infant, Child, Youth with Public Health Practice. When she is not nursing, Randi enjoys crafting, practicing yoga, learning to garden and being a mom! She is passionate about raising awareness for mental health and advocating for women, children and families.

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Human milk banking: Getting breast milk to the babies that need it most

(Co-authored with Katherine Schemenauer, Clinical Practice Lead at the University Hospital of Northern BC’s Neonatal Intensive Care Unit)

A poster promoting the donation of breast milk.Did you know that there are four human milk banks in Canada? We are lucky to have one in BC: the BC Women’s Provincial Milk Bank, in Vancouver. This milk bank provides screened, pasteurized donor breast milk to hundreds of tiny, sick, or at-risk babies every year. Babies in the Neonatal Intensive Care Unit (NICU) at the University Hospital of Northern BC (UHNBC) in Prince George are amongst these recipients.

Why is donor human milk important?

The gift of donor milk is life-changing for the smallest, sickest, and most vulnerable babies. When mothers are unwell, deliver their babies prematurely, or their babies are born sick, they may not have enough of their own milk in the first few days to provide for their own babies. The processed donor milk provides a safe, easy to digest first milk for their babies until they can grow stronger, and their mothers can provide enough of their own milk for their babies.

Human milk has been shown to reduce the incidence of Necrotizing Enterocolitis (NEC) in newborns. NEC can be life threatening to an already at-risk baby. Human milk is easy to digest, making it the best option for premature digestive systems.

What is a donor milk collection depot?

A milk depot is a place where eligible donors can drop off their breast milk donations, once they have gone through a screening process. These depots then send the milk to the provincial milk bank in Vancouver for processing. Currently, there are 24 donor milk collection depots in BC, based out of hospitals and health units. Northern Health has one depot in Prince George, at UHNBC, in the NICU.

Northern Health uses donor milk in the NICU

The NICU at UHNBC uses up to 3 litres of human donor milk for up to 15 babies a month. Most babies in the NICU need between 12ml (less than a tablespoon) to 500ml (2 cups) of donor milk a day.

Got milk?

Women who are interested in donating their milk are welcome to contact the BC Provincial Milk Bank to learn more.

Additional resources:

Jeanne Hagreen

About Jeanne Hagreen

Jeanne has been a Lactation Consultant since 1993. She worked for Northern Health for 38 years, first as a nurse on the Maternal-Child Units, then 20.5 years as a Lactation Consultant. During this time, she also returned to school and earned her BSN from UNBC. Following her retirement at the end of September 2015, Jeanne has remained an active member of local, regional & provincial perinatal committees. She is also co-president of the BC Lactation Consultant Association. Jeanne was born in Whitehorse, Yukon and also lived in Campbell River, Victoria, Toronto and Vancouver. In 1975, she moved to Prince George with her husband and two small sons. In addition to her volunteer work, she is an avid knitter and reader. She enjoys living in the rural community of Salmon Valley with a small menagerie of animals, along with the wildlife that passes through her yard.

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