Breastfeeding Friendly Physician Offices

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1 Breastfeeding Friendly Physician Offices Jennifer Stewart, R.D., M.B.A., CLS Loving Support Breastfeeding Program, Riverside County Department of Public Health Susanna Sibilsky, Regional Breastfeeding Liaison, Shasta County HHSA - WIC

2 AAP Recommends The WHO Ten Steps to Successful Breastfeeding 1. Have a written breastfeeding policy that is routinely communicated to all health care staff. 2. Train all health care staff in the skills necessary to implement this policy. 3. Inform all pregnant women about the benefits and management of breastfeeding. 4. Help mothers initiate breastfeeding within the first hour of birth. 5. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants. 6. Give newborn infants no food or drink other than breast milk, unless medically indicated. 7. Practice rooming-in (allow mothers and infants to remain together) 24 h a day. 8. Encourage breastfeeding on demand. 9. Give no artificial nipples or pacifiers to breastfeeding infants. * 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from hospital. * The AAP does not support a categorical ban on pacifiers because of their role in SIDS risk reduction and their analgesic benefit during painful procedures when breastfeeding cannot provide the analgesia

3 Impact of Physician Encouragement Lu, et al found Provider encouragement significantly increases breast-feeding initiation among American women of all social and ethnic backgrounds. three-fold among young, low income, and less educated women nearly five-fold among black women nearly eleven-fold among single women

4 Affordable Care Act The law requires insurance companies to cover preventive services without cost sharing requirements including: Breastfeeding support, supplies, and counseling: Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their children s and their own health. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.

5 So how can WIC help with breastfeeding friendly medical offices? The sky is the limit when we develop relationships

6 Riverside County Department of Public Health Breastfeeding Friendly Physician Program 6

7 History The Riverside County Department of Public Health Loving Support Breastfeeding Program received funding from First 5 Riverside - Children and Families Commission (Prop 10) in 2001 Funding was for a 24 hour Breastfeeding Helpline and a physician outreach program We also received a one-time WIC grant to provide education to physicians. This was the beginning of the Breastfeeding Friendly Physician Program Began in 2005 Physicians could obtain this designation by achieving the 7 steps 7

8 Goal The goal of the grant was to provide seamless services for the women of Riverside County. That they would receive the same breastfeeding messages from their OB provider, WIC, the hospital and their Pediatric provider. To support the AAP recommendation that infants are exclusively breastfed throughout at least their first year of life. 8

9 Our Vision, Our Program Our Vision: Breastfeeding Representatives (patterned after pharmaceutical representatives) selling the idea of breastfeeding to doctors. Breastfeeding Representatives market breastfeeding to physicians, nurses and other health professionals so that, in turn, they market breastfeeding as their expectation of how their patients feed their babies.

10 In the beginning Our staff was trained on how to approach the physician staff initial contact, getting the agreement signed, setting up the exam room, follow-up contact Our staff went to re-stock the displays every 2 weeks. Very important to start a relationship with the offices 10

11 Loving Support OB Displays

12 Formula does not stack up to Breastmilk

13 Office Visits Breastfeeding Representatives Visit over 250 offices quarterly Stock wall displays Bring: WIC information, updated breastfeeding research, local resource lists -Very important we were able to offer our 24 hour Breastfeeding Helpline Information Entered Into Data Bank When pregnant women call our Helpline we mail them an Infant Feeding Package and enter information into our database for future calls.

14 Doo-dads and Paraphernalia Just as pharmaceutical reps have done in the past - we have given the following outreach materials to offices: Lunch boxes, coffee mugs, lanyards, badge holders, pens, notepads, wall clocks( Time to breastfeed ),clipboards, wall calendars. All have our bf message and Loving Support information. 14

15 Breastfeeding Friendly Physician Designation We also received a one-time WIC grant to provide education to physicians. This was the beginning of the Breastfeeding Friendly Physician Program Began in 2005 Physicians could obtain this designation by achieving the 7 steps 15

16

17 Lunch and Learn Topics Breastfeeding Facts Revealed--formula does not stack up to breastmilk Staying on Track - Do you know the stations for help? (train theme) 3 step counseling- what to say to Moms Are you Making the Grade?-Achieving Breastfeeding Friendly Just One Bottle

18 WIC Regional Breastfeeding Liaison Program In 2010, our First 5 funding for our BF Friendly Physician Program ended. In October 2010, we received a grant from WIC Regional Breastfeeding Liaison grant to continue our Breastfeeding Friendly Physician Program.

19 Regional Breastfeeding Liaison Beginning 2011, WIC Nutritionists based regionally are making quarterly visits to physician offices to: Promote the new WIC breastfeeding program, Provide WIC outreach materials, Share Loving Support information Provide breastfeeding education and research updates Assess for Breastfeeding Friendly status

20 Important points about our program We have been around for so many years that offices trust we won t disappear They have had good feedback about our services Our staff remain constant so a rapport can be developed Staff gave their business cards so an office could contact them if they had questions We brought food Several of the years we offered 1 CME for attending the L and L. We have a 24 hour Breastfeeding Helpline 20

21 What s going on in Shasta County 2004 Breastfeeding Support Center First 5 Shasta Funding Provided a small amount of Peer Counseling 2007 Breastfeeding Support Center came under auspice of WIC Continued support for all women in Shasta County 2009 First 5 Shasta funding to support Peer Counseling 2010 CA WIC Grant to significantly expand Peer Counseling and Fall 2010 CA WIC funding for the Regional Breastfeeding Liaison Project Initial goals: Re-form regional coalition with the addition of social media networking opportunity Connect with healthcare provider community

22 Connecting with Healthcare Providers Provider input on Toolkit Private practice and clinic providers OB/GYNs, Peds, Family Practice, Residents Offer trainings during staff meetings and lunch breaks Using Your Toolkit Changes to WIC We are not the formula people How to Teach Breastfeeding Messages Common Problems Simple Solutions Understanding Baby Behaviors Looking at providing CEUs

23 What We Learned from the Focus Group Preferred clinician to healthcare provider Want the facts Status of breastfeeding duration in the county Bulleted information How to refer for breastfeeding support Residents need the basics Suggested having a breastfeeding mom come to a training as a show-n-tell

24 Some of the Facts 95% 85% 90% 86.3% Mercy Medical Center BF Initiation 84.6% Meyers Memorial Hospital BF Initiation 75% 65% 55% 45% 43% 38% 35% 31% 28% 25% WIC Prenatal Intention to BF WIC Exclusive BF 1 month WIC Exclusive BF 2 months WIC Exclusive BF 4 months WIC Exclusive BF 6 months

25 In Support of Breastfeeding Clinician Toolkit Features Highlights Peer Counselors Highlights breastfeeding duration rates Maximizing Revenues Clinician Education and Resources Updated with 2012 AAP Policy Statement and WHO Growth Charts Breastfeeding Referral Forms WIC Program Services Patient Education and Resources

26 Before you leave the office Ask: What step can you make today to be a more breastfeeding friendly office? And let them know how WIC can help

27 Toolkit Training Comments This training increased my awareness and handy materials for the moms I will encourage our WIC patients to get a peer counselor Talk more with patients about breastfeeding in public or when they go back to work Knowing there are breastfeeding resources I can tell patients about Asking for more breastfeeding trainings

28 Additional Training Topics Breastfeeding 101 Common Problems Simple Solutions How to Teach Breastfeeding Messages Baby-Led Latch Breastfeeding Myths and Misconceptions Understanding Baby Cues

29 Questions? Contact information: Jennifer Stewart, R.D., M.B.A., CLS Riverside County Department of Public Health Lactation Services Susanna Sibilsky Regional Breastfeeding Liaison Shasta County HHSA WIC

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