Volunteering With Breastfeeding Buddies

Are you interested in becoming a Breastfeeding Buddy?

Our program trains new peer volunteers twice a year – once in the Fall and once in the Spring.

At this time applications for the next training are being accepted. Once your application has been reviewed you will be contacted to start the onboarding process.

All volunteers must have a minimum of 6 months personal breastfeeding, chestfeeding or pumping experience, and must reside in Waterloo Region.

The training is provided free of charge to you. Full attendance plus completion of personal guided learning is required.

Free limited childcare is provided, and babies in arms are welcome in the training room.

First Name *

Last Name *

Email *

Phone Number *

Do you live within Waterloo Region?
YesNo

Which Region do you live in?

Please note, due to our current funding, all of our volunteers must reside in Waterloo Region. By entering your Region above, and pressing the "send" button, we will be able to demonstrate a need for a peer support program in your area. Should we receive funding to expand our training, we will be in touch at a future date. We thank you for your interest, and hope to offer volunteer opportunities in your community soon!

Which dates are you available to train? (if you are available for more than one opportunity, please select all that apply)
Spring 2024 (May 10 - 11, 2024)Fall 2024 (November 29 - 30, 2024)

What is your home address?

What is your age?

What are your Pronouns? *optional
check one or more options for the set of pronouns you want people to use when they refer to you
---She/HerThey/ThemZe/HirXe/XirHe/HimSomething Else

Is English your second language?
YesNo

The language I speak most often at home is:

What other languages can you speak?

What is your highest level of school completed?
--Grade 8High SchoolCollegeUniversityTrade School

What is your postal code?

How did you hear about volunteering for the Breastfeeding Buddies peer support program of Waterloo Region? Please check all that apply.
Family/FriendRegion of Waterloo Public Health (Website, nurse, program)MidwifeObstetricianDoctor/Nurse PractitionerOntario EarlyOn CenterGrand River HospitalCambridge Memorial HospitalHad a Breastfeeding BuddyAttended the Me Breastfeed WorkshopAttended the Baby & Me Breastfeeding Drop InAttended Virtual ProgramsBreastfeeding Buddies WebsiteBreastfeeding Buddies Facebook PageNone of the Above

Please tell us the name of the person who referred you

Please list your work or volunteer experience that may be relevant to the Breastfeeding Buddies volunteer program.

Please upload a copy of your resume if you wish.

Please list two references we can contact during the application process. This should be someone who will say you are a supportive, reliable, and caring individual (does not need to be an employer, but should not be an immediate family member! A friend, coworker, teacher, neighbour, etc)

Reference 1 First Name *

Reference 1 Last Name *

Reference 1 Email

Reference 1 Phone Number

Relationship to you

Reference 2 First Name *

Reference 2 Last Name *

Reference 2 Email

Reference 2 Phone Number

Relationship to you

How old were you when your first child was born?

Did you breastfeed (or chestfeed) your first child?
YesNo

For how long?
0 to 3 Months3 to 6 Months6 to 12 Months12 to 24 MonthsOver 24 Months

Did you breastfeed (or chestfeed) your second child?
YesNoI do not have more than one child

For how long?
0 to 3 Months3 to 6 Months6 to 12 Months12 to 24 MonthsOver 24 Months

Did you breastfeed (or chestfeed) your third child?
YesNoI do not have more than two children

For how long?
0 to 3 Months3 to 6 Months6 to 12 Months12 to 24 MonthsOver 24 Months

Did you breastfeed (or chestfeed) your fourth child?
YesNoI do not have four children

For how long?
0 to 3 Months3 to 6 Months6 to 12 Months12 to 24 MonthsOver 24 Months

The next section asks about your personal breastfeeding or chestfeeding experience. Please check all that apply (may be your own or someone very close from whom you have gained excellent insight).

Do you have experience with?
Pre-mature BirthCesarean SectionTwinsPostpartum Depression/AnxietyNipple ConfusionLow Milk SupplyHigh Milk SupplyHigh Needs Baby (Fussy or colicky)Poor LatchSore/Cracked/Bleeding NipplesPlugged DuctsMastitisSlow Weight GainBitingLack of breastfeeding support (Family, friends, partner)Nursing Strike (Baby refuses to nurse)Tongue TieIllness/Surgery (Child)Allergy (Child)Cleft LipCleft PalateSleepy BabyJaundicePumpingThrush (Yeast)Breast ImplantsBreast ReductionMilk StorageProblems Labour/DeliveryReturning to Work/School (While Breastfeeding)

Is there any other breastfeeding or chestfeeding experience you feel would be beneficial as a Breastfeeding Buddy (including any additional information from the above categories)?

This section asks about your personal life experience. Please check all that apply (may be your own or someone very close from whom you have gained excellent insight).

Do you have lived or living experience of any of the following? Please only share if you would be comfortable having this information as part of your 'helping profile'.
Please note that this information will be kept strictly confidential according to our privacy policy.
I am living on a limited income (I have had to visit food banks, I sometimes don't have money for rent)I am living in unstable housing (I am on a waiting list for for housing, I have stayed at a shelter)I am new to Canada (I have lived in Canada less than five years)I don't have many social supports (Family, friends, neighbours, community groups)Single parenthoodIllness/Health condition (Mother)Surgery (Mother)Mental HealthAddiction or Substance UseDomestic Violence/AbuseI prefer not to answerNone of the above

Any other life experience you feel would be beneficial as a breastfeeding buddy? (including any additional information from the above categories).

What supports and or services did you use in your breastfeeding experience?
Family/FriendsPhysicianMidwifeAttended the Me Breastfeed WorkshopCambridge Memorial Hospital Breastfeeding Buddies ProgramAttended Breastfeeding Buddies Baby & Me Drop In Group(s)/Virtual ProgramsHad a Breastfeeding BuddyLa Leche LeagueLactation ConsultantPublic Health Phone or Home VisitCommunity Support Site (Pre-Natal Nutrition, Busy Babies, Circle of Families, Playgroup, Breastfeeding Site)None of the above

Permissions and Consents

I give permission for Community Healthcaring KW and the Breastfeeding Buddies Program of Waterloo Region to use my name, address, and phone number to tell me about Breastfeeding Buddies of Waterloo Region programs/services, newsletters, and evaluations?
--YesNo

I am willing to be contacted by a member of the Breastfeeding Buddies of Waterloo Region research team at some point in the future to learn more about the Lyle Hallman Grant and Study project and my possible participation?
(Consent can be withdrawn at any time. This will not affect your application or program participation in any way. Choosing yes gives our researchers permission to contact you to ask if you are willing to take part once you have been given more information about the study). Participating in this study is your choice (voluntary). You have the right to choose not to participate, and you have the right to withdraw from the study and stop your participation at any time. here will be no consequences to you or the services you receive.
--YesNo

I am willing to be contacted by authorized students and volunteers about Breastfeeding Buddies of Waterloo Region activities?
--YesNo

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone Number *

Thank you for your interest in becoming a Breastfeeding Buddy! Your application will be reviewed and you will be contacted.

Please note there are a limited number of training spots. The 3 day training is free and attendance at all three days is mandatory. Babies are welcome in the training room, and childcare spots are available for older siblings

By checking this box, you are giving permission for the Breastfeeding Buddies Program to receive this form via email and use your email address to communicate with you. While all precautions are taken to ensure security and privacy, email can be vulnerable to misuse. Please do not include any confidential health information on the form.

Fall Training November 29th 9:30 am - 3 pm and November 30th 9:30 am - 4 pm

Are you interested in becoming a Breastfeeding Buddy?

Thanks for your interest in the Breastfeeding Buddies Program of Waterloo Region.

Our program trains new peer breastfeeding volunteers once a year in May based on our current funding.

At this time applications for the November 2024 training are being accepted. Once your application has been reviewed you will be contacted.

Please note there is a limited number of training spots, so not all applicants are guaranteed a spot.

The 3 day training is free and full attendance is mandatory.

Free limited childcare is provided to those in need.