The committee met at 12:05 p.m.

[N. Simons in the chair.]

N. Simons (Chair): Good afternoon. Welcome to the Select Standing Committee on Children and Youth, two days in a row. It’s nice to see everybody back here and to welcome new guests, who will be providing some information on the report that was released a few months ago now, August.

Without further ado, why don’t we ask the representative to open with some comments.

Welcome again.

Consideration of Joint Reports

Promoting Access to Breastfeeding
in Child Welfare Matters

J. Charlesworth: As a way of beginning, too, I just wanted to acknowledge the territories of the Lekwungen-speaking peoples, specifically the Esquimalt and Songhees Nations, on whose traditional lands we have the opportunity to gather today.

Good afternoon. I am pleased to be here again to meet with members of the committee and to join the Ministry of Children and Family Development in presenting our joint report, Promoting Access to Breastfeeding in Child Welfare Matters.

I’d like to introduce members of our team: the deputy, Alan Markwart, whom you know well already; our executive director of advocacy, Blair Mitchell here; chief investigator Carly Hyman; senior investigative analyst Karen Nelson. All of whom were integrally involved in the writing of this report. I also want to, on the record, acknowledge Linda Hughes, who is not here today but who is the executive director of monitoring and strategic initiatives. She had a strong hand in this as well.

This report was released by Minister Conroy and my predecessor, Bernard Richard, on August 29 of this year and was the second joint report with the ministry since the representative’s office began in 2007, the first being a joint report on placements of children in care in hotels.

This report was initiated after a high-profile case this past spring, which you’re no doubt aware of, in which the B.C. Supreme Court ordered MCFD to increase an Indigenous mother’s access to her infant for breastfeeding and bonding. Shortly after the B.C. Supreme Court’s decision, the Provincial Court ordered that this infant be returned to the mother, finding that MCFD had not adequately considered the supports that were available in her First Nations community to keep the family together.

After discussions with the ministry about this case, our office concluded that we shared many of the same systemic concerns around access to breast milk and bonding opportunities in child welfare cases, and we determined that a joint report was the best way to deal with these concerns in a timely way rather than an RCY investigation, which would have taken much longer and likely resulted in the same outcome and action plan being prepared by MCFD.

As part of this joint work, we collaborated with MCFD to examine what policies and practices could be enhanced or introduced to strengthen families’ capacity to care for their infants, support access to breastfeeding or breast milk, and potentially prevent the unnecessary removal of infants. As the report notes, this project was in keeping with Hon. Ted Hughes’s vision in 2006, when he recommended that the representative take part in the development of policies or practices that reflect a deeper understanding of the needs and interests of children, youth and their families.

The report considered MCFD data on infants who entered care within 12 months of birth as well as RCY advocacy data in cases where access to custody or custody to support breastfeeding had been a factor. It was also informed by a review of relevant literature, a look at policies and programs in other jurisdictions and visits to model support programs at FIR Square and Sheway in Vancouver.

As part of this report, we reviewed 110 RCY advocacy files from early 2013 to mid-2018 that involved access to support breastfeeding. There were a number of challenges we identified in these cases.

Notably, social workers were faced with differing medical opinions about the safety of breast milk in cases involving mothers who were on a methadone management program or using substances.

Second, in cases where domestic violence was an issue, the need to assure safety caused interruptions to breastfeeding.

Third, cultural considerations for Indigenous families around access and breastfeeding were not always apparent or considered in the planning.

[12:10 p.m.]

Fourth, inconsistent prebirth planning. Many families felt that MCFD or the DAA, delegated Aboriginal agencies, had not engaged with them enough to allow sufficient access for bonding and breastfeeding.

Finally, issues around supervision and access to facilitate breastfeeding in cases where a child had been removed.

With regards to the ministry’s data, the report showed that, on average, between 2013-14 and 2017-18, more than 500 infants 12 months old or younger entered government care in B.C. annually. Nearly 60 percent of these infants were Indigenous, which is a particularly significant figure when one considers the ongoing overrepresentation of Indigenous children in care.

In 2017-18 alone, 188 infants who were less than seven days old were brought into government care. These numbers are significant, and they pointed to a problem that I believe this report has taken an important step forward on.

A lot of very young lives have been starting out away from their families, and these babies are generally missing out on opportunities and the lifelong benefits of early bonding and breastfeeding. For too many, this is the beginning of a childhood in care.

As the report states: “The overrepresentation of Indigenous children and youth in care begins with the decision to bring a child into care in the first place. It’s…imperative that practices that result in fewer children entering care are considered and implemented in B.C.” That was, in fact, a consideration that you were deliberating on yesterday afternoon.

While each family’s situation is unique and it is complex to balance an infant’s right to nutrition and connection with their right to safety, MCFD and RCY are in agreement that guidelines must be put in place and steps must be taken to promote family unity wherever possible.

The action plan contained in this report, which Alex Scheiber, deputy director of child welfare, will elaborate on next, is designed to help social workers promote breastfeeding and focus on keeping infants with their parents, with community support when needed and when safe to do so.

Our office will be tracking implementation of the steps in the action plan to ensure that the potential this plan represents translates into tangible actions.

Before I finish, I’d like to acknowledge the sentiments expressed by some of the Indigenous community that MCFD and RCY failed to adequately engage Indigenous leaders in the development of this report. While leaders subsequently acknowledged and supported the findings, they also noted that we missed an important opportunity for engagement. We recognize and respect that.

B.C.’s delegated Aboriginal agencies were asked for input as part of the process, but in retrospect, it was insufficient when examining an issue that affects Indigenous families disproportionately.

Since then, we’ve acknowledged the need to be more engaged and have taken concrete actions with First Nations Leadership Council and the delegated Aboriginal partnership table. We will endeavour to continue to better consult and include Indigenous views going forward.

Thank you. I would be happy to answer any questions following MCFD’s portion of the presentation.

N. Simons (Chair): Thank you very much, Represen­tative.

It’s a pleasure to welcome Alex back. I think you’ve been here a few times. Welcome. We look forward to your presentation on the report.

A. Scheiber: Thank you, and good afternoon, Members.

Thank you for your opening comments, Dr. Charlesworth. I want to thank you and your predecessor, Bernard Richard, and your staff, for the opportunity to collaborate with the representative on another important project that has great promise in terms of improving services to vulnerable children and youth in families in B.C.

As you said before, this is the second joint report — the first being the hotel report in 2016. I always find that these joint projects are a great opportunity to improve services. I enjoy working with your staff too. I just wanted to let you know that.

My presentation today is an overview of the report Promoting Access to Breastfeeding in Child Welfare Matters. I’ll be covering some of the methodology, the findings, the action plan and the next steps. I don’t expect this will be a long presentation, so there will be lots of opportunities for questions.

Mr. Chair, are people able to ask questions as we go through, or do you want to hold…?

N. Simons (Chair): Let’s hold questions until the end, if that’s all right with the members.

Okay. We’ll let you go sailing through.

[12:15 p.m.]

A. Scheiber: Okay. As the representative has said, the genesis of this report was a very high-profile situation in Port Alberni where an infant had been removed by the ministry. Some of the issues that came out in the B.C. Supreme Court and subsequent court proceedings really centred around not only whether the director, or the ministry in this case, used least disruptive measures, which we have to do whenever we consider removing children, but also focused a lot on the infant’s right to access breastfeeding. That was a key feature in this situation.

As Dr. Charlesworth said, the approach and the vision of doing these reports was very much consistent with Justice Hughes, who recommended that the RCY and MCFD take part in the development of policies and practices related to children, youth and families. So we really started out with that vision in mind.

As was said before, we wanted to look at what the data said on our numbers of removals of infants. We wanted to look at what our policies were. We wanted to do a scan of policies around the world. We wanted to see what lessons there would be in terms of improving services and service delivery models when we’re practising and when we’re providing services to children and families. We wanted to look at what kinds of strategies and what the literature says around strategies — what effective strategies there are to support families and what things we could do to prevent or reduce the removals of infants.

The methodology that we used. As Dr. Charlesworth said, we conducted a review of the literature on children’s rights. We looked at the literature on child welfare as it applies to infant removals and promoting breastfeeding. We looked at Indigenous-specific literature and the effect of opioids and HIV on breastfeeding. We looked at milk banking as well.

We asked the Directors of Child Welfare across Canada…. I chair that committee, so I was able to approach each of the directors and ask them what kinds of policies and guidelines and programs they have that promote breastfeeding in circumstances where infants are in need of protective services. We looked at what policies and programs existed in Australia, New Zealand and other countries as well.

Then we looked at our own database on infant removals to see what it could tell us. Unfortunately, our database doesn’t tell us a lot of information about infant removals or children removals. It tells us, as you were saying before, Dr. Charles­worth, the number of removals within certain periods of time. So we looked at the numbers of removals of infants under the age of a week old and under 30 days old and under a year old. It tells us a little bit about why children were removed, in terms of the broad categories under the Child, Family and Community Service Act. We need to do some further analysis of that, and I’ll get to that later in the presentation.

We also looked, of course, at the advocacy files; the RCY examined those. We were very fortunate to be able to include in the report some vignettes that could help the readers understand and help us understand what the issues were when providing services to expectant mothers and mothers with newborns and their families.

We also went to FIR Square. FIR Square is a program — there are actually a number of beds; I think there are eight beds — at B.C. Women’s Hospital. We visited that program. We work a lot with FIR Square and Dr. Abrahams. They provide beds for mothers with addictions who have newborns. That program has been in place since the early 2000s and has been hailed worldwide as being a leading-edge program. So we wanted to know more about the effectiveness of that program.

We also looked at the Sheway program, which is a program provided…. It’s a joint program between the Ministry of Health and MCFD that operates, again, for addicted parents in the Downtown Eastside.

[12:20 p.m.]

The purpose of those visits was really to understand what programs have promise in working with primarily mothers of newborns. I should say that most of the cases that we looked at were mothers that were involved in addictions and had addictions issues. So there was resulting neglect and risk for the infants.

The literature findings were as follows. Since 2013, an average of 475 infants per year are removed under the age of 12 months. That’s quite a significant number. There’s not a trend that we could see. We looked back four years. We couldn’t see any kind of…. There’s a gradual downward trend, but it’s not significant.

We can be pretty sure, at least over the last five years, that on average, we’re looking at close to 500 infants being removed, and 188 of those infants were under the age of seven days. The most common issue was neglect, as Dr. Charlesworth said. Unfortunately, sadly, most of the infants were Indigenous. Although it’s sad, it’s also not entirely a surprise because, as you all know, Indigenous children are sadly overrepresented in the child-in-care population. This is no different when we’re looking at infants.

When we looked at the scan of other jurisdictions, we didn’t see any jurisdictions — including Australia, New Zealand or across Canada — that had guidelines or policies that were specific to working with child welfare services that would provide guidance or direction to social workers, child protection social workers, around promoting breastfeeding or working with this population. We saw lots of evidence of programs that worked, like FIR Square and Sheway. There were other approaches that worked.

Interestingly, as I say, we didn’t see any specific policies around this. My own feeling about that is that it’s an emerging area. It’s an area where we are gradually paying much more attention to it, but I think, so far, we don’t have specific policies. That’s something we need to do. We have guidelines in B.C. and policies for working with parents with addictions, but it doesn’t get into working specifically with newborns and promoting breastfeeding.

The report also showed that prevention is absolutely key. Planning and services must be in place to mitigate the risks so that infants are not removed. That’s an important area for us to be working on in the next few months and year.

We are exploring options and ways of working in a more preventative fashion. We know from programs like Sheway, where social workers work with nurses and our public health nurse visiting program, that it’s important to get in early to provide support services. If we wait until we get a child protection report and things have deteriorated, often we end up, sadly, having to remove. Once a child is removed, it’s much more difficult, because there are bonding issues. Promoting breastfeeding is a difficult thing to support in some situations. So prevention is really everything.

The report also found that if we can look at and examine residential programs that support mothers of newborn babies in a multidisciplinary way with nurses and social workers…. If we can provide that supportive, supervised environment, then we can serve even very high-risk infants in a safe way.

[12:25 p.m.]

I know that there are some countries like New Zealand that have mother-baby homes, where, if it’s necessary to take a child into care, an infant into care, they actually take the whole family into care. They are all placed with caregivers in a supervised environment where bonding continues to happen and breastfeeding can take place.

We have a couple of very small examples of that in B.C. But we don’t have a program yet for that, and that’s one of the things that we’ll be exploring with Housing and other partners. I think it’s something that we need to expand significantly, not just programs like FIR Square and Sheway, but also, we need to have the ability, where infants are at risk and where we have the ability, to place the child and mother together. We’ve got some ideas about that.

The report also found that we need more strategies for enhancing access to breast milk and alleviating the barriers. In the Port Alberni case, one of the barriers was that, quite honestly, we didn’t have the supervisors available to be able to supervise the mother’s breastfeeding and access to the child on the amount of time that was required. Most of our supervision programs look at having a parent have access to a child for two or three hours a day, once a day. That doesn’t work with breastfeeding. You need to have a much more intensive and longer-term approach.

The court in that situation ordered an extraordinary amount of supervision, and we of course complied with that. One of the things we realized is that we don’t have an infrastructure or the ability, necessarily, the capacity to be able to provide that service, and we need to be able to do that.

So we need to look at prevention. We need to look at where infants do need to come into care. And there will always be situations where that is necessary. We need to look at mother-baby homes or supportive housing. Lastly, we need to look at, if we can avoid a removal, a supervised environment where the mother can continue to stay with the baby. All of those things are important.

I’ll just go on to the next slide here. The action plan. In the report, there were five actions. The first action was that MCFD will review and update its practice directive on working with expectant parents with high-risk behaviours, with respect to considering additional practices and guidelines for social workers to plan with families to help mothers and their infants remain together, including the role of extended family and communities in supporting mothers and infants.

There’s a lot in that. As I said before, we do have guidelines for working with expectant parents with high-risk behaviours, but it doesn’t really get into the issue of some of those other practices that we need to expand on.

One of the things we’re doing in preparation as we’re developing these guidelines, and we will be consulting quite significantly with stakeholders on this, is we’re going to be looking and taking a deep dive into the files of all the infants we’ve removed. We’re going to try to understand not just the numbers, where they’re taking place. We’re looking at what strategies have been used; what their trajectories are; how long they stay in care; if they’ve returned home, what strategies were effective.

We’re going to be looking at all sorts of aspects of those files, and we’ve got a group of people, directors of practice, working on those. Obviously, the more we can understand the cohort and what has worked and what hasn’t worked, the better our guidelines will be. So that has some promise, I think.

The guidelines that we have will also talk about strategies for promoting breastfeeding in circumstances where infants have been removed. Just, again, expanding on the strategies that I mentioned before — supportive housing, supervision models that work for newborns and their mothers.

We’ll also be looking at, you know, again, with B.C. Housing, supportive models for mothers where infants don’t need to come into care. Even prior to a child needing protection, what can we do that will serve the general population? There are many mothers and families and children who are vulnerable, but they don’t come to the ministry’s attention. We want to make sure that we work with community partners to be able to serve that population better so that we don’t have to provide the protective services.

[12:30 p.m.]

N. Simons (Chair): Just to interrupt, I’m mindful that I think there are a lot of questions ready to be asked. I appreciate it, and I’m just noting that.

A. Scheiber: Okay. I’ll wrap it up pretty quickly here.

The fourth action was the Ministry of Health and the Ministry of Mental Health and Addictions will work with MCFD and Indigenous partners to continue to increase access to evidence-based programs that provide prenatal and postpartum care for women who use substances.

The fifth and last action was that RCY’s advocate outreach initiatives will target stakeholders who provide services to expectant mothers. That work is underway, and certainly, as we develop guidelines and policies in the ministry, we’re going to be incorporating the work that Blair is doing and the RCY is doing on the advocacy, too, and make sure that we tell social workers clearly what the options are for advocacy and the benefits of advocates in these types of situations.

The last slide is the next steps. We’re consulting with key stakeholders as we develop the policies. We’ll be doing that over the next year, so we will be going to Indigenous groups and others as we develop these guidelines. We want to make sure that these are fulsome and thorough and that they resonate with every community.

The Ministry of Mental Health and Addictions reports that through the early action initiatives, the federal funding was allocated in 2018-19 and is notionally allocated in 2019-20 and 2020-21 to expand best-practice, community-based mother-baby care for pregnant women who use substances, and management of withdrawal in newborns. So that’s an exciting program that Ministry of Mental Health and Addictions is working on.

As I said before, the RCY advocacy staff are planning outreach initiatives targeting key communities, service providers and hospital staff who work with expectant mothers, in an effort to increase awareness of the support, advice and direct advocacy RCY can provide. Plans include a large mailout for November 2018 to organizations across the province, providing information about RCY advocacy services, with invitations for RCY staff to meet with them in person.

That concludes my presentation. I’ll open it up for questions.

N. Simons (Chair): Thank you very much. We have a few people with questions.

I have a question, just if I may, to start. That has to do with the guiding principles of the CF and CS Act, which seem to me, already, to state quite clearly that kinship ties and children’s attachment to their families should be preserved, along with their cultural identity. What isn’t happening…? How is it that we’re deciding that we need to find ways of keeping children with their families when that’s, in fact, one of the guiding principles of the act? I’m just not sure how that’s something new.

A. Scheiber: I’ll take this. I don’t think that that principle is anything new. Of course, it’s been around for close to 25 years, and social workers are aware of those principles, and they are good principles. I think some of the barriers that we face in serving newborns and their mothers where there’s a risk are some of the ones that I mentioned during the presentation. It’s lack of housing available to place mothers and babies together. We don’t have supervisors that we can hire that are necessarily available on the timelines that are required to promote breastfeeding.

We don’t necessarily have, to be honest, services that are necessarily tailored to this. We have a suite of services that we contract to provide services to families of children of all ages, but we don’t necessarily have service providers or services that we know are effective when working with these families. These are situations, often, where there’s severe poverty, where there’s domestic violence. There are serious child protection issues, and we need to know what we can do that will both keep the infant safe and maintain bonding and breastfeeding.

[12:35 p.m.]

M. Stilwell (Deputy Chair): Thank you, Alex, for the report and for the work of the special project to bring some of the issues to light so that we can better understand and better support children and families along the way. I think it’s great that you’ve been looking at services and practices around the world in order to formulate better plans for us.

I just want to look at some conflicting data in the report that I found and that I want to, hopefully, get some better understanding from. On page 13, the last paragraph before the heading of “Breastfeeding Special Circumstances” says: “While it is generally assumed that breastfeeding enhances the maternal-infant bond, much of the literature concludes that there is no empirical evidence that this is the case. The quality of the attachment bond is predicated on the quality of the maternal-infant relationship rather than the method of feeding.”

In the conclusion of the report, in the first paragraph, it actually says, “In the context of child welfare matters, when an infant is removed from the birth mother, the infant is generally deprived of his or her right to the nutritional benefits of breast milk, which research shows has long-term impact on healthy development,” but then it says: “Research also shows that breastfeeding promotes attachment.” It conflicts with what you said earlier in the report.

J. Charlesworth: I’d like to invite Karen Nelson, who did the review of the literature and is steeped in this….

Do you want to take a stab at that?

K. Nelson: Yeah, I’ll take a stab at that.

My instructions were to do a lit review in very specific, the five, domains that I think Alex quoted. The feminist perspective on breastfeeding is a little bit different from, say, what a child welfare perspective might be for a mom in the Downtown Eastside who’s struggling with substance misuse. There is conflicting literature, and we were specifically not going into attachment theory specifically in a deep kind of a way, but I needed to point to it a little bit. So yes, it’s complex, and it’s conflicting.

Also, another piece of criticism is the other parent’s role, whether that be a father or another same-sex parent or what­ever, so I wanted to accurately reflect the conflict. Our reports are written…. The lit review was done first, and the conclusion was written later. So it may look like a conflict, but both those things are true. Breastfeeding is best, but it isn’t always best, and it isn’t always necessary. That bond is important. If breastfeeding can’t happen, sometimes with HIV or other circumstances, a healthy relationship with an adult is also good.

I don’t know if that answers it.

M. Stilwell (Deputy Chair): It does. I just worry that many people who read reports often skim reports and don’t see all the details of the report. So is there a way that you can rewrite that description and understanding in the conclusion — because many people will read the beginning and the end — so that is reflected for those people?

K. Nelson: Yeah. I think, internally, we maybe need to do a little bit of work around that, around how to incorporate academic literature in a report that is very targeted to a certain demographic. I think that’s a very important point that we can take under advisement, for sure.

M. Stilwell (Deputy Chair): Perfect. Thank you.

And if I may, Chair, just one other quick little thing.

N. Simons (Chair): Sure, Deputy.

M. Stilwell (Deputy Chair): The timeline of the action plan — there are no actual dates associated with the action plan bullets. Are there any? Do you have time frames for them?

A. Scheiber: Yeah, they’re all in the report itself. I didn’t go over them, but I can if you want to. September 2019 are some of them. March 2019. The earliest one has actually just passed — September 30, 2018. That’s around the advocacy services that the RCY is initiating.

M. Stilwell (Deputy Chair): Perfect. Thank you.

J. Charlesworth: Page 25.

A. Scheiber: Yeah, 25.

S. Furstenau: I read this report with great interest. It certainly reinforced a lot of things that we see in Cowichan.

I want to point out one of the things that isn’t stated outright, I think, when we look at, on page 21, the Sheway pregnancy outreach program — that 80 percent of the women who access services have lived in foster care–type arrangements themselves. So we are talking about intergenerational impacts of the system.

Then we look, on page 20, from the FIR Square, 85 percent of women who were on opioid agonist therapies reduced to 14 percent when rooming-in with infants.

[12:40 p.m.]

There is a piece of the puzzle here that’s not explicit, but it is implicit in the report that the benefit of this bond, the maternal bond, is a benefit to the mother and the child, and often the mother is left out. I appreciated that when we talked about FIR Square and Sheway in here, both consider the pregnant mother, or mother and infant, as a team, which I think is, ultimately, the root of the impetus of this report. It’s saying we can’t just look at the infant as one individual and the mother as a completely separate entity.

With that in mind, and going to the action plan, my concern about the action plan is that it is focused very much on reviewing and updating policies and guidelines and options and strategies. I would say that in terms of the conditions that are being stated by everybody who’s paying attention to this file, we’re in a humanitarian crisis. To me, this feels a bit akin to: “The forest fires are burning, and we’re going to come up with a really good plan by the end of next year for how we’re going to put out forest fires.”

There are, in this report, very concrete examples of successful models. So what I would prefer to have seen in the action plan were the words “funding” and “implementing.” There are communities right now that are asking for exactly these kinds of models — FIR Square, Sheway, supportive housing. We can come back a year from now and say: “Wow, these programs would be really good for these communities,” and we’re one more year, with 500 more infants apprehended.

The other grave concern I have…. I think that when you look at audits of the practice standards that are currently in place, and those audits demonstrate that in many regions, there’s an astonishingly low adherence to practice standards, there is a distinct, subjective interpretation of how serious those practice standards are. To bring forward new policies and new guidelines that don’t have the force of law and can be interpreted subjectively…. I think we are going to still be at this table a year from now, saying “Wow, it’s a terrible situation. We have these policies now. Let’s see how they play out for another year.”

I think there needs to be more urgency. I think there needs to be a recognition that funding models that are proven to be successful, in Vancouver with FIR Square…. We need to see funding happening, not new policies. We know the outcomes. The research is there that demonstrates all of this.

It’s not much of a question, but I really…. Getting to the end of this report, it’s: “We’re still going to look at the problem, and we’re going to bring policies.” This doesn’t change the lives of these women and their babies right now. I’m hoping we can shift much more to a proactive funding approach as soon as possible.

N. Simons (Chair): I would add, Sonia, that probably the question you have is: could we?

S. Furstenau: Yeah. Can we, now?

N. Simons (Chair): Let that be the question.

S. Furstenau: Thanks, Mr. Chair.

I just wanted to identify that this was the inconsistency. I get to the end of the report, and I get to the action plan. The concrete outcomes that you’re trying to achieve, based on what is outlined in this report, won’t be achieved by these actions. They will be achieved by funding the models that work.

N. Simons (Chair): Feel free to respond, any of you.

A. Scheiber: I really appreciate your comments, Sonia. I couldn’t agree with you more that this is a very urgent issue, with 500 infants in care. And 20 percent of all the kids in care are coming into care every year. Again, the younger the children come into care, the longer they stay in care. That’s what the research shows.

If we’re going to change the trajectory and reduce the numbers of children in care significantly, particularly Indigenous children, we have to break the cycle. I absolutely agree with you. I also agree with you, having worked in policy shops before and been an auditor, that those things sometimes have some effect, but they don’t have a lot of effect without concrete strategies like the ones you’re talking about, with resources, funding.

I’d love to be able to say yes. I’d love to be able to commit to those things. I can say that we are working on other things that are outside this report, with partners, and I’m very hopeful.

[12:45 p.m.]

I see a lot of momentum in government, not just in our ministry but in other ministries as well, to try to bring some resources to this area.

I’m hopeful. I’m optimistic that in a year’s time, as you say, when we talk about this again, maybe the world won’t be changed, but things will be improved a lot. I’m pretty hopeful that we will be able to reduce, even within that period of time, the number of infants, but we have to get it right. We have to come up with some concrete strategies. I completely agree with you.

N. Simons (Chair): Thank you. I have a question, and then Joan has a question. Do we know…? Did we compare the number of infants removed from parental care with other jurisdictions? Is the ratio the same across Canada, or not?

A. Scheiber: We didn’t look at that. That’s something we can look at. Again, as I said, I chair a committee of directors across Canada, and the issues that we deal with, particularly around Indigenous children, are very similar across Canada. In some places, it’s a greater crisis than it is here; in others, it’s a little bit better. We know that there are significant numbers of infants that come into care across Canada, everywhere.

I don’t know the numbers, but what we were interested to know was what is working and what isn’t working. We didn’t see, apart from some programs we saw that were promising — like in Calgary, and other places — a lot of strategic resources and emphasis being put into this area. I’m hoping that some of the work we’ll do here will be leading edge.

N. Simons (Chair): Thank you very much. I’m hoping some of it might be addressed in our poverty reduction strategy.

One thing, before I pass it to Joan, is that I didn’t see any mention of women in custody, women in jail, and what programs might exist for women who are recently incarcerated or who have a child of breastfeeding age or even older.

Let me go to Joan, and maybe you can incorporate some of the response to that in there.

J. Isaacs: I’m not clear how I’m going to actually position this comment. I’m still kind of working through it. My first question is: when we talk about neglect and that children are being removed for neglect…? I’m sorry. I just really don’t know what that means. What does that mean? What activity or non-activity is captured that really warrants the removal of a child because of neglect?

A. Scheiber: The report talks about it, and our data tells us that neglect is a broad term. It means, under the act, that a child has been or is likely to be harmed physically. Neglect is defined that way in the law. There are some subcategories of neglect that talk about a parent’s ability or unwillingness.

In many of these cases, we saw that as a subcategory. Parents — either mothers or fathers, or both — were unable or unwilling to care for the child. That was one of the things. We also saw situations where the parents were so severely addicted or had other issues, like domestic violence, that they just simply didn’t have the capacity.

You know, capacity changes over time, right? With infants, you have a very small margin for error. They’re so vulnerable that social workers, unless they can see clear measures that are available to keep the child safe, will tend to move to removal, or taking the child into care by agreement, if there are no other measures available.

Neglect has some subcategories, but those are some of the reasons that we saw in the data. Again, we need to do a deeper dive into that. We actually have to go through physical files and look at what social workers said before we can really get a good handle on what they were seeing in these files. Our electronic databases only contain certain codes.

N. Simons (Chair): Is that good, Joan?

J. Isaacs: Can I just make this one statement? I don’t know if it’s really a question yet. On page 13 of the report, we’re talking about colostrum, the first milk, and how important it is. Immediately I had taken the assumption that if the mother was healthy, there would be no transference of harmful effects. Then later on, on page 14 — I immediately thought of hep C or HIV — it says that the transmission risk in hep C and HIV is less than 1 percent.

[12:50 p.m.]

This I thought was quite alarming, quite interesting, but then we go back to the breastfeeding for opioids. It sounds like, in the beginning, the literature is clear that breastfeeding is safe if you’re on a harm reduction therapy. But then later on, it kind of goes….

The American Academy of Breastfeeding Medicine supports it during the pregnancy, but it doesn’t really say what happens after. It speaks about supporting breastfeeding initiation rates and early attachment, but it doesn’t really specifically say if they are suggesting breastfeeding after the baby is born, if you know what I mean.

It just was very, very confusing. I wasn’t sure just how big the report was that you got your information from and if there would have been anything in the report to suggest the other side or another opinion in the report.

K. Nelson: Another opinion, as in…?

J. Isaacs: In just saying that maybe someone would say that the effects are not known or….

K. Nelson: There’s absolutely no evidence in any literature to say that a drug-using mom shouldn’t breastfeed. If there are no child protection issues, the Canadian literature…. There was a positive literature in Canada, but the Americans have been ahead in that for a while. Just before the report was released, so it wasn’t included in the lit review, I believe the Canadian Paediatric Society…. I found a piece of literature suggesting rooming in and breastfeeding, but just before they actually made a directive to physicians to not disrupt that ever with opiate use, any substance use. Even in HIV, it’s considered safe.

It’s interesting, the comments from the MLA here. The idea around supporting the mom was profoundly what we heard at FIR Square. We had the opportunity to meet moms — in fact, a mother that I know from my work that has been involved quite extensively in child welfare in the province. What we saw was that with appropriate supports, all of these women, the majority of these women, do well.

It’s not a Pollyanna sort of picture, where all of them will be able to keep their babies, but over time, the dyad can stay together with appropriate supports. Poverty is usually present, and as soon as you have appropriate supports, appropriate medical supports and appropriate parenting supports — all of those things — these moms love their babes like all of us do, and they do alarmingly well.

I think the ratio was 75 percent of the time staying with their biological moms, whereas prior to FIR Square, none of these children were getting the chance. So when we’re looking at intergenerational issues, this seriously disrupts that pattern of children coming into care because they’re poor or they’ve been in Indian residential schools or any of the colonial aspects.

There’s no evidence to support removing a mom or not letting a mom, other than legitimate child protection.

N. Simons (Chair): Rick, you had a comment or question.

R. Glumac: Yes, I guess I’ll keep it short, since you don’t have much time. I had some questions around: how did it get to the point that this had to go to the B.C. Supreme Court? And how is it that after all that, the child was returned to the mother? A question of how that all happened and whether that’s going to continue to happen? It’s such an extreme amount of effort that needs to go in to correct a situation that seems to have challenges there with rights, maybe, of the parents — something I raised before.

Just to keep it short, can you guys come back with a new set of action items that aren’t just changing policies? Things like actually setting your goal to: how can we address this problem within a year? Then come back to us, and then we can have another conversation.

A. Scheiber: We can, yeah. Just to address this issue about how this happened, without getting into the specifics of that case, I can tell you that we are working closely with the Huu-ay-aht First Nation.

[12:55 p.m.]

We’re very excited to be working with them this fall, actually, and into the winter, around an agreement with them that will hopefully never — and I’m optimistic here — result in another infant of that nation being taken into care. They are very interested and committed and passionate about their infants and their children. So we’re very optimistic that by working with them and building in the supports that are necessary, we can….

Again, it’s all really about prevention, hopefully. But yes, we can do that.

N. Simons (Chair): I’d like to thank everybody for their attention and interest in this issue and for the work that was done on this report. Thank you very much for doing that. Thank you for the presentation. We learned a lot, and I know we probably wanted to stay longer.

Committee members, I’ve asked for you not to be fined for being late for caucus, and we will meet again.

I ask for a motion to adjourn.

Motion approved.

The committee adjourned at 12:56 p.m.