breastfeeding friendly physician offices€¦ · and a physician outreach program we also received...
TRANSCRIPT
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
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
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
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.
So how can WIC help with
breastfeeding friendly
medical offices? The sky is the limit when we develop
relationships
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Riverside County
Department of Public Health
Breastfeeding Friendly Physician
Program
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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
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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.
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.
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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
Loving Support OB Displays
Formula does not stack up to Breastmilk
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.
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“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.
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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
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
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.
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
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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
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
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
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
Some of the Facts
90%
43%
38%
31% 28%
25%
35%
45%
55%
65%
75%
85%
95%
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
■ 86.3% Mercy Medical Center BF Initiation
■ 84.6% Meyers Memorial Hospital BF Initiation
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
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
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
Additional Training Topics
Breastfeeding 101
Common Problems…Simple Solutions
How to Teach Breastfeeding Messages
Baby-Led Latch
Breastfeeding Myths and Misconceptions
Understanding Baby Cues
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