Objectives. Oklahoma Health 1/24/2013

Transcription

1 Oklahoma s Breastfeeding Activities and Hotline: Positive Steps to Reducing Infant Mortality Rebecca Mannel, BS, IBCLC, FILCA Lactation Center Coordinator & Baby-Friendly Oklahoma Project Lead University of Oklahoma (OU) Health Sciences Center Department of Obstetrics & Gynecology (OB/GYN) Nancy Bacon, MS, RD/LD, CDE MCH Nutrition Consultant Oklahoma State Department of Health (OSDH) Objectives Review Oklahoma s breastfeeding activities Describe development and implementation of the Oklahoma Breastfeeding Hotline Describe new Baby-Friendly Oklahoma project Oklahoma Health Oklahoma ranks: 39 th for infant mortality 43 rd for diabetes 45 th in obesity 46 th in preterm births 46 th in teen birth rates 47 th in smoking 43 rd in overall health ranking America s Health Rankings, 2012 OSDH 1

2 Oklahoma Breastfeeding Rates 2009(CDC) National Oklahoma Ranking Ever breastfed (BF) 77% 71% 38 th Any breastfeedingat 6 months 47% 33% 43 rd Exclusive BFat 6 months 16% 10% 45 th Excess Health Risks Associated with Not Breastfeeding Excess Outcome: Health Full Term Risks InfantAssociated Excess with RiskNot Breastfeeding SIDS 56% Death in first year 27% Childhood Obesity 32% Type 2 Diabetes Mellitus 64% Oklahoma s Breastfeeding Legislation 2004: Breastfeeding in public; jury duty 2005: Resolution to support working breastfeeding mothers 2006: Workplace breastfeeding legislation 2

3 Breastfeeding Workgroup Purpose: Increase the %of mothers who breastfeed their infants at 6 months of age. Activities: Outline specific breastfeeding activities that will improve maternal & infant outcomes. Coordinate with the Special Supplemental Nutrition Program for Women, Infants, & Children (WIC) to plan and promote the annual WIC Breastfeeding Conference. Provide consistent breastfeeding messages. Breastfeeding Workgroup Maintain the Breastfeeding Website Support the Oklahoma Breastfeeding Hotline MILK (6455) Support the Oklahoma Hospital Breastfeeding Education Project Increase the number of Baby-Friendly hospitals in Oklahoma Providing Optimal Care for Breastfeeding Initiation Curriculum for Hospital and Community-based Health Care Providers Continuing Education Program 3

4 Oklahoma Breastfeeding Hotline Jointly supported by: Maternal and Child Health Title V Block Grant OU Medical Center OU Health Sciences Center OB/GYN Department Pre-Conception OU Medical Center Lactation Center provided 24/7 telephone support for breastfeeding families delivering at OU MILK Had received calls from across Oklahoma and even other states International Board Certified Lactation Consultant (IBCLC) staff stressed to provide inpatient care and telephone support Conception Interested parties: OSDH Maternal and Child Health OSDH/WIC Oklahoma Health Care Authority (OHCA - the state s Medicaid Agency) OU Medical Center (OUMC) OU Health Sciences Center (OUHSC) Department of OB/GYN 4

5 Birth Plan IBCLC phone services available 24/7 Available to any breastfeeding mother or family member Available to any healthcare provider Referral source for and to WIC Breastfeeding Peer Counselors, La LecheLeague (LLL) leaders, other mother-to-mother support groups Referral source for closest available outpatient lactation services Labor Initial funding: OSDH/MCH = $12,000 OSDH/WIC = $25,000 Other funding requested Signed contract received by OUHSC OB/GYN Department 9-08 Labor Resource books purchased for IBCLC use when on call Toll-Free Number reserved Toll-Free Number purchased and activated Number transferred to OUHSC vendor

6 Birth Hotline answered during business hours by IBCLCs on duty at OUMC/OUHSC Administrative costs absorbed temporarily Initial marketing costs handled by WIC Additional Marketing: - Conference presentations/displays -Prenatal classes - Websites and news releases - Oklahoma Resource Directory and Hotline Flyer - Television & radio spots Early Postpartum During business hours M-F, hotline answered or paged IBCLC directly After hours and weekends, callers could leave a message or page IBCLC directly Non-urgent messages returned the next morning during business hours Covering Costs of Care As volume increased: Need to pay for cost of IBCLC who is NOT seeing patients Need to cover administrative costs Need training/updates for IBCLC staff Need electronic documentation Cost of marketing 6

7 Covering Costs Maternal and Child Health explored additional funding sources for hotline Explored options for electronic documentation to save costs Minimized administrative overhead Continued Growth and Development Hotline Coordinator oversees: Scheduling Online database Timesheets Quarterly/annual reports OB Department Lactation Manager oversees: Contract Personnel management Reporting requirements Current Status Core team of IBCLCs who each take 24 hour call days Use their personal mobile phones Calls answered by return call from IBCLC Non-urgent calls returned during business hours Urgent calls returned within 1 hour Documentation in online database 7

8 Documentation Required Each phone call: Date of call Age of mother and baby Ethnicity of caller Reason for call, time of call Referrals made Quarterly and annual reports to submit Include data on calls Most common concerns of callers Statistics/Data : 3,100 total calls 45% urgent 55% non-urgent Time of day of calls (July-Sept. 2012) 60%: business hours ( 8am 4pm) 36%: evening hours ( 4pm 12am) 4%: middle of night (12am 8am) Statistics/Data Maternal status 64%: Primiparous 36%: Multiparous Maternal ethnicity 61%: Caucasian 7%: Latina 6%: Black 3%: American Indian or Asian 23%: Other/declined 8

9 Births By Ethnicity (Kaiser Family State Health Facts 2010) OK (%) US (%) White Black American Indian Asian Hispanic Statistics/Data Contact rate 77% spoke with caller 21% left message 2% no contact Age of baby when calling 57% are birth-5 weeks 39% are 6 weeks 12 months 4% are >12 months Statistics/Data Most common reasons for calling 19%: Milk production 16%: Infant issues 14%: Medications 9-10% each: Breast, pump, latch issues Most common referrals 41%: Outpatient lactation services 35%: Health care provider 11%: County health department/wic 9

10 Challenges/Opportunities Blocked calls Staff training/orientation Text messages/ Video/Skype calls? Caller satisfaction survey Outreach among minority populations Oklahoma Hospital Breastfeeding Education Project 42 birthing hospitals participating Offer Making Breastfeeding Easier classes Statewide, 7.5 contact hours Sponsor Breastfeeding Continuing Education Program (BCEP) 5-50 books/hospital Baby-Friendly Oklahoma Goals: Improve exclusive breastfeeding rates at hospital discharge Improve duration rates Reduce Oklahoma infant mortality and child/adult obesity rates 10

11 Baby-Friendly Hospital = Optimal Breastfeeding Care Two main components: Ten Steps to Successful Breastfeeding No marketingof breastmilk substitutes in the hospital Baby-Friendly hospitals do not accept or distribute free or low-cost supplies of breastmilk substitutes, nipples or pacifiers. Baby-Friendly Environments Reduce Disparities All babies should have skin to skin contact All babies should stay with moms All moms deserve educated staff All moms deserve commercial-free hospital care Hospitals Encourage Breastfeeding by Not Giving Formula Bags AREA Oklahoma City Metro Area 11 Tulsa Metro Area 3 Other Areas of State 9 Numberof Birthing Hospitals Bag-Free by 2012 These 23 hospitals deliver more than half of the babies born in Oklahoma! 11

12 Baby-Friendly Oklahoma Received line item funding in July 2012 Recruiting 10 pilot hospitals, Sept Host Baby-Friendly Oklahoma Summit All birthing hospitals invited to send team March 1, 2013 Continue to recruit 10 hospitals/year Shepherd through Baby-Friendly process Stipends and portion of Baby-Friendly USA fees paid Baby-Friendly Oklahoma Partners Baby-Friendly Oklahoma July 2012 June 2013 Year One -Recruit first group of 10 hospitals Hospitals will: Sign a commitment letter to implement 4 of the 10 Steps in 1 st year Participate in kickoff conference call/webinar Complete Baby-Friendly USA Discovery phase (1 st 2 months) Register, CEO support letter, self-assessment Begin Baby-Friendly USA Development phase Policy, staff training, patient education Baby-Friendly Oklahoma provides: Website Resources Model Policy Baby-Friendly Curriculum (15 nursing contact hours) Regional Train the trainer skills labs (verify competency) Regularly scheduled conference calls for hospital teams 12

13 Additional Statewide Breastfeeding Activities Partnering with Oklahoma Blood Institute (OBI) Statewide OBI locations Existing courier system for pickup and delivery Quality donor screening Parallel statewide missions! For more information: Special thank you to Mothers Milk Bank of North Texas for all their support! Future donor Questions? Rebecca Mannel, BS, IBCLC, FILCA, Lactation Center Coordinator Baby-Friendly Oklahoma Project Lead Ph: (405) Nancy Bacon, MS, RD/LD, CDE MCH Nutrition Consultant Ph: (405)

14 Breastfeeding Saves Billions: Fund Breastfeeding Support Breastfeeding prevents many costly chronic diseases in mothers and children and acute illnesses in infants. More than $13 billion per year could be saved by strengthening government leadership and policy infrastructure to support breastfeeding. Not breastfeeding increases health risks. The medical evidence shows that breastfeeding lowers the baby s risk of infections, diarrhea, SIDS, obesity, diabetes, asthma, and childhood leukemia, and lowers the mother s risk of breast and ovarian cancers and diabetes. 1 A 2009 study of nearly 140,000 women found that women who breastfed for at least one year were 10-15% less likely to have high blood pressure, diabetes, high cholesterol, and cardiovascular disease compared to mothers who never breastfed. Benefits were seen in women who breastfed for a minimum duration of 6 months, but the longer a woman breastfed, the better. 2 Cardiovascular disease is the No. 1 cause of death for women in the U.S. Doctors recommend 1-2 years of breastfeeding, but mothers need more support. All major medical authorities recommend that babies get no other food or drink other than human milk for their first 6 months and continue to breastfeed for at least the first 1-2 years of life Authorities include the AAP, ACOG, AAFP, WHO, CDC, DHHS, and USDA. However, only 12% of U.S. mothers are exclusively breastfeeding at 6 months, and only 21% are still breastfeeding at 1 year. 7 The CDC and FDA recently found that 60% of women do not even meet their own breastfeeding goals. The U.S. loses billions when breastfeeding fails. LOST: At least $13 billion/year in the U.S. 8 for premature deaths and other costs of diseases and conditions caused when infants are not breastfed. Runaway health care costs are due, in part, to the many diseases and conditions that are preventable or reduced in severity by breastfeeding. Approximately 10% of the Healthy People 2010 health objectives for the nation would be met or improved if breastfeeding were adequately supported. Policy Gap: Inadequate federal leadership and coordination. Research studies have shown that hospital practices, workplace policies, and state legislation powerfully influence the success of breastfeeding mothers, 9 but there is no central government leadership to encourage the implementation of improved practices. As a result, breastfeeding is more difficult than it should be. U.S. government publications have repeatedly called for better policy support for breastfeeding as a cost-effective disease prevention measure. 10 Excess Health Risks Associated with Not Breastfeeding Outcome: full-term infants Excess risk Acute ear infection % Diarrhea and vomiting % Hospitalization for lower 257% resp. disease in first year 13 Childhood obesity 13 32% Type 2 diabetes mellitus 13 64% SIDS 13 56% Death in the first year 14 27% Outcome: mothers NEEDED: Fund breastfeeding support in implementation of health care reform. Excess risk Breast cancer 13 4% Ovarian cancer 13 27% Include breastfeeding education and support in the activities of new interagency working groups created by the PPACA. Interagency Working Group on Health Care Quality National Prevention, Health Promotion and Public Health Council HHS Coordinating Committee on Women s Health Include breastfeeding support in all preventive services. As Senator Kennedy said, The best way to treat a disease is to prevent it from ever striking. 11 Breastfeeding support services should be included as a key component in all preventive services, including Medicaid coverage for professional health care providers, services provided by community health centers, support to ensure access to such services by all mothers, and promotion of the Baby-Friendly Hospital Initiative for better maternity care practices in hospitals. 12 A well-coordinated government infrastructure is needed for breastfeeding support. Require health professional training. Physicians, nurses, and other health professionals receive little to no training in the support of breastfeeding mothers. All medical and nursing schools should be required to provide training in lactation support to meet the core competencies as recommended by the United States Breastfeeding Committee.

15 References and Notes 1 Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Rockville, MD: Agency for Healthcare Research and Quality; Evidence Report/Technology Assessment No Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, Cauley JA. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol. 2009;113(5): American College of Obstetricians and Gynecologists Committee on Health Care for Underserved Women and Committee on Obstetric Practice. Special report from ACOG: breastfeeding: maternal and infant aspects. ACOG Clin Rev. 2007;12(1)(suppl):1S- 16S. 4 American Academy of Family Physicians. Family Physicians Supporting Breastfeeding (position paper). Accessed May 31, American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk (policy statement). Pediatrics. 2005;115(2): World Health Organization/UNICEF. Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland: World Health Organization; U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Breastfeeding: Data and Statistics: National Immunization Survey (NIS). Accessed May 31, Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048-e Shealy K, Li R, Benton-Davis S, Grummer-Strawn LM. The CDC Guide to Breastfeeding Interventions. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; U.S. Department of Health and Human Services. HHS Blueprint for Action on Breastfeeding. Washington, D.C.: U.S. Department of Health and Human Services, Office on Women's Health; Kennedy EM. Health bill would fix what's broken. Op ed. Boston Globe. May 28, 2009:A Breastfeeding-related maternity practices at hospitals and birth centers--united States MMWR Morb Mortal Wkly Rep. 2008;57(23): U.S. Department of Health and Human Services. The Surgeon General s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics. 2004;113(5):e435-e439. 6/1/2009 BoD 7/15/2011 SGCTA 2025 M Street, NW, Suite 800 Washington DC Phone: (202) FAX: (202) office@usbreastfeeding.org Web site:

16 VOLUME 2 ISSUE 2 August 2012 Duration and Exclusivity of Breastfeeding in Oklahoma Breastfeeding, specifically exclusive breastfeeding, is known to provide immediate benefits to infants and mothers and long-term protection from chronic health problems that lead to morbidity and mortality. Infants with a family history of diabetes, who have been breastfed exclusively for at least four months, have a decreased risk of developing Type 1 Diabetes, and a decreased risk of developing asthma and eczema. The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend exclusive breastfeeding for approximately the first six months of life. 1 Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) data in this Brief will focus only on mothers who initiated breastfeeding. Because new mothers are surveyed between 2-6 months postpartum, the longest duration that can be reasonably measured is nine weeks. Figure 1 highlights the initiation and duration (at eight or more weeks) rates from Although largely stable there does appear to be a slight upward trend in both initiation and duration at Percent eight or more weeks after Changes in the survey occurred between 2008 and 2009, including minor changes to the initiation of breastfeeding question. Therefore, the remaining analysis will discuss only the period, for continuity. Data show 76.1% of new mothers initiated breastfeeding in The Healthy People 2020 goal for breastfeeding initiation is 81.9%. Initiation and duration rates (to eight weeks or more) are available by maternal race in Figure 2. None of the identified groups met the Healthy People 2020 initiation goal. Although initiation rates from were high, the majority of infants who were breastfed were not breastfed to at least eight weeks (55.0%). Among those mothers who breastfed less than eight weeks: 61.2% were years old 25.3% had less than a high school education 12.8% were American Indian 29.4% were obese (Body Mass In- Figure 1: Trends in Breastfeeding Initiation and Duration of Eight Weeks or More, Oklahoma PRAMS Year Initiation Breastfeed 8 + weeks OKLAHOMA FACTS 76.1% of new mothers initiated breastfeeding in More than half of breastfed infants in were breastfed less than eight weeks (55.0%). 72.0% of mothers who breastfed for less than eight weeks utilized Medicaid/ SoonerCare for prenatal or delivery care. Almost 1/3 of breastfeeding mothers stopped exclusively breastfeeding their infants in the first week. Half of infants in Oklahoma were exclusively breastfed less than 3.8 weeks. 32.8% of infants were exclusively breastfed for 9 or more weeks. The three most commonly given reasons for stopping breastfeeding (and mothers could select more than one) were: Not enough milk (51.0%) Latching problems (27.3%) Mother returned to work or school (17.9%)

17 Percent Percent Figure 2: Breastfeeding Initiation and Duration of Eight Weeks or More by Maternal Race, Oklahoma PRAMS dex (BMI) of 30.0 or above) 72.0% utilized Medicaid/SoonerCare for prenatal or delivery care 29.8% had a household income of less than $10,000 per year 53.3% were unmarried 18.6% reported symptoms of postpartum depression 69.6% had WIC during their pregnancy 63.8% lived in rural areas 7.2% did not have a well baby checkup within one week postpartum 14.5% did not receive counseling or advice from their prenatal care provider on breastfeeding Because AAP and WHO recommend exclusive breastfeeding for at least 6 months, PRAMS data also were reviewed to look at duration and exclusivity to identify characteristics associated with exclusive breastfeeding. Figure 3: Length in Weeks of Exclusive Breastfeeding Duration, Oklahoma PRAMS <1 week 1-2 weeks 3-8 weeks 9 + weeks Length of Duration White Black American Indian Maternal Race Initiation Breastfed 8 weeks The median duration for exclusive breastfeeding (defined as feeding the infant only breastmilk, no other liquids including water, formula, juice, etc.) was 3.8 weeks. One-third of infants were breastfed exclusively for less than 7 days (33.1%, See Figure 3). However, 32.8% were exclusively breastfed for nine weeks or more (the longest duration PRAMS can measure due to sampling methods). The most common reasons given for stopping breastfeeding among all mothers who attempted breastfeeding were (and mothers could choose more than one): Didn t have enough milk (51.0%) Baby had difficulty latching (27.3%) Mother went back to work or school (17.9%) It was too painful (14.1%) It was too time consuming (9.7%) Eighteen percent of women wrote in comments about why they stopped breastfeeding; these included the infant s health status, other children in the household, the mother s health status, and personal preference, among others. Reference: 1. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. 129(3), March We have a great pediatrician and without her I would have given up breastfeeding. - PRAMS Mom ACKNOWLEDGEMENTS Special Assistance for this piece was provided by Nancy Bacon, MS, RD/LD; Binitha Kunnel, MS; Alicia Lincoln, MSW, MSPH; and Rebecca Mannel, BS, IBCLC (OU Health Science Center). Funding for PRAMS is provided by the Centers for Disease Control and Prevention (CDC) and the Maternal and Child Health Bureau, Department of Health and Human Services, Maternal and Child Health Services (MCH) Title V Block Grant.. PRAMS is a population-based surveillance system about maternal behaviors and experiences before, during, and after pregnancy. Approximately 250 mothers are selected to participate in Oklahoma each month. Mothers are sent as many as three mail questionnaires seeking their participation with follow-up phone interviews for nonrespondents. Information included in the birth registry is used to develop analysis weights that adjust for probability of selection and non-response. Prevalence rates were calculated and the potential risk factors were identified using the Cochran-Mantel-Haenszel Chi-Square (χ 2 ) Test. The sample size for was 5,937 with a response rate of 68.7%. The Oklahoma State Department of Health (OSDH) is an Equal Opportunity Employer. This publication was issued by the OSDH, as authorized by Terry Cline, PhD, Commissioner. 1,800 copies were printed by OSDH in August 2012 at a cost of $522. This publication is available for download at <

18 Nursing Your Newborn Strong & Healthy Begins with Breastfeeding Breastfeeding is Going Well When:* Your baby nurses 8 or more times in a 24-hour period (about every 2 to 3 hours) Your baby has at least 3 wet diapers a day during the first few days and at least 6 wet diapers a day by the end of the first week Your baby has 3 or more yellow, loose bowel movements a day by the end of the first week You can see your baby sucking and hear swallowing while nursing Your full breasts are softer after the baby nurses Your baby seems satisfied after nursing Breastfeeding Benefits for Your Baby: Provides the best nutrition for your baby Contains the best nutrients that your baby needs for the first 6 months of life** Protects against illnesses such as ear and respiratory infections Decreases allergies Creates a special bond between you and your baby Supports brain development Lowers risks of obesity and diabetes * These guidelines are for healthy term babies. For those with special needs or specific questions, please contact your healthcare provider or call the Oklahoma Breastfeeding Hotline at MILK (6455). **The American Academy of Pediatrics recommends that all babies receive 400 IU of Vitamin D each day starting at birth. After six months of age, your baby may have a need for fluoride. To check the fluoride level in your community s water, view My Water s Fluoride at Talk to your healthcare provider about the need for a vitamin D or flouride supplement. Adapted from Nursing Your Newborn-Breastfed Babies are Healthier Babies American Academy of Pediatrics New York Chapter 2 Nutrition Committee.

19 Tips for Successful Breastfeeding It s best if your baby nurses within the first 1 to 2 hours after birth Skin-to-skin contact is good for your baby and can help increase your milk supply Nurse your baby every 2 to 3 hours Early and frequent breastfeeding will allow your milk supply to increase to meet your baby s needs Do not give your baby water or formula unless directed by your healthcare provider Breastfeeding can take some work and practice to get you and your baby used to each other, so give it some time Breastfeeding Benefits for You Convenient Breastmilk is free Always readily available to feed your baby Helps you lose your pregnancy weight faster Helps your uterus return to its normal size faster Lowers your risk of breast and ovarian cancer May lower your risk of heart disease Help is Available Your baby should be seen by a breastfeeding educated healthcare provider 2 to 5 days after discharge and again at 2 to 3 weeks of age Your baby s healthcare provider and your lactation consultant can provide help and support during your breastfeeding experience Mothers and healthcare providers with breastfeeding questions can call the toll-free Oklahoma Breastfeeding Hotline at MILK (6455) For help and support, please call your local WIC Clinic or For more information, visit the Oklahoma State Department of Health Breastfeeding Information and Support Website: STOP BY, CALL OR VISIT OUR WEBSITE Preparing for a Lifetime, It s Everyone s Responsibility Maternal and Child Health Service - Oklahoma State Department of Health 1000 Northeast Tenth Street, Oklahoma City, OK Phone Fax AN EQUAL OPPORTUNITY EMPLOYER This publication was issued by the Oklahoma State Department of Health, as authorized by Terry Cline, Ph.D., Commissioner of Health. 4,000 copies were printed as part of a set by Heritage Solutions in June 2010 at a cost of $10,500. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Funding provided by the Title V Maternal and Child Health Block Grant, Maternal and Child Health Bureau, Department of Health and Human Services.

20 MILK (6455) OKLAHOMA BREASTFEEDING HOTLINE We are pleased to provide the Oklahoma Breastfeeding Hotline. The hotline is available free of charge to nursing mothers, their families and partners, as well as expecting parents and health care providers in need of breastfeeding support and information. 7 days a week, 24 hours a day Staffed by International Board Certified Lactation Consultants (IBCLCs) - OU Medicine Lactation Team Supported by Oklahoma State Department of Health (OSDH) Maternal and Child Health (MCH) Service, OU Medical Center, and OU Health Sciences Center OB/GYN Department Callers may leave a message for a return call that day. For urgent issues, the IBCLC on call may be paged. Accurate, up-to-date information for common breastfeeding issues: Not making enough milk Baby refusing to nurse Breast or nipple pain Medications and breastfeeding Working and breastfeeding Breast pumps Breastfeeding in public Weaning Referrals to: Women, Infants, and Children (WIC) Programs Outpatient lactation services available in Oklahoma La Leche League breastfeeding support groups Breast pump rental locations Milk banks for mothers milk donations * Please note that the hotline cannot provide a medical diagnosis. All medical questions should be directed to a health care provider MILK (6455) OKLAHOMA BREASTFEEDING HOTLINE

21 afact SHEET Baby-Friendly Oklahoma Summit Baby-Friendly Oklahoma is a statewide effort to help Oklahoma birthing hospitals improve maternity care and to increase the number of Baby-Friendly hospitals in Oklahoma. Purpose Provide Oklahoma Birthing hospitals support to work toward Baby-Friendly Hospital designation Offer a statewide Baby-Friendly Hospital Summit to educate maternity care leaders and promote steps toward the Baby-Friendly designation March 1, 2013 Baby-Friendly Oklahoma Summit 1 day conference for all Oklahoma birthing facilities Location: OU Health Sciences Center Samis Education Center 1200 N. Phillips, Oklahoma City (same entrance as Children s Hospital) Time: Conference free of charge Hospitals invited to send a leadership team (of at least 3) to learn ways to implement the Ten Steps to Successful Breastfeeding $ travel reimbursement provided to teams attending the March 1 st Summit Agenda to follow Presentations by nationally known Baby-Friendly experts, including the Executive Director of Baby-Friendly USA Goals Improve exclusive breastfeeding rates at hospital discharge Improve duration rates Reduce Oklahoma infant mortality rates Contact Becky Mannel, BS, IBCLC, FILCA Anne Merewood, MPH, PhD, IBCLC Baby-Friendly Oklahoma Project Lead Baby-Friendly Oklahoma Project Consultant OUHSC Department of OB/GYN Associate Professor of Pediatrics office Boston University School of Medicine rebecca-mannel@ouhsc.edu Oklahoma Hospital Breastfeeding Education Project Partner Links: Oklahoma Hospital Association Featured Content - Home Office of Perinatal Quality Improvement - OPQI Preparing for a Lifetime, It s Everyone s Responsibility Welcome To The Oklahoma Health Care Authority

22 FACT SHEET Baby-Friendly Oklahoma Baby-Friendly Oklahoma is a statewide effort to help Oklahoma birthing hospitals improve maternity care, and to increase the number of Baby-Friendly hospitals in Oklahoma. WHY DO WE NEED BFHI? Thousands of infants in the United States suffer the ill effects of suboptimal infant feeding practices. The benefits of breast-feeding are well documented. In the United States, these benefits could translate into millions of dollars of savings to our health care system through decreased hospitalizations and pediatric clinic visits. For diarrhea alone, approximately 200,000 US children, most of whom are young infants, are hospitalized each year at a cost of more than half a billion dollars. Many of these cases of diarrhea could have been prevented with breast-feeding. The CDC s mpinc survey revealed that 24% of birth facilities reported supplementing more than 50% of healthy, full-term breastfed infants. Through various studies we have learned: Women giving birth where supplementation rates were lowest were more likely to exclusively breastfeed. The longer a mother waited to initiate breastfeeding, the more likely she was to use formula. Exclusive breastfeeding during the hospital stay is one of the most important influences on how long babies are breastfed exclusively after discharge. WHAT IS THE UNICEF BABY-FRIENDLY HOSPITAL INITIATIVE? The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. The BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feed formula safely, and gives special recognition to hospitals that have done so. The Ten Steps to Successful Breastfeeding for Hospitals 1. Maintain a written breastfeeding policy that is routinely communicated to all health care staff. 2. Train all health care staff in skills necessary to implement this policy. 3. Inform all pregnant women about the benefits and management of breastfeeding. 4. Help mothers initiate breastfeeding within one hour of birth. 5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. 6. Give infants no food or drink other than breastmilk, unless medically indicated. 7. Practice rooming in --allow mothers and infants to remain together 24 hours a day. 8. Encourage unrestricted breastfeeding. 9. Give no pacifiers or artificial nipples to breastfeeding infants. 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge. Adapted with permission from Miami-Dade County Baby Friendly Hospital Project September 2012.