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Bureau of Nutrition & Physical Activity 321 E. 12th St. | Des Moines, IA 50319

1.800.532.1579 | WICHD@IDPH.IOWA.GOV

Week ending June 22, 2018 | Issue #380

___________________________________________________________________ Policies from the WIC State Program Services Manual

Policy 310.29 WIC Breastfeeding Peer Counselor Coordinator Guidelines and Qualifications

1 of 2 Breastfeeding Peer Counselor Coordinators are responsible for managing the local WIC agency breastfeeding peer counseling program and working in partnership with the state WIC office. Breastfeeding Peer Counselor Coordinators are required to: Be a licensed dietitian or registered nurse; Receive state-approved training in breastfeeding management; Participate in continuing education about breastfeeding annually; and

Receive “Using Loving Support to Manage Peer Counseling Programs” training. Note: The breastfeeding peer counselor coordinator may or may not be the local agency breastfeeding coordinator. The following experiences and skills are desirable: Experience in program management; Expertise in breastfeeding management and promotion; Credentials of an International Board Certified Lactation Consultant (IBCLC) or has other

certification in lactation management (e.g., CLE, CLC) or state-approved training in lactation management;

Basic computer skills; Minimum of one year experience counseling breastfeeding women; and

Have personal breastfeeding experience. The breastfeeding peer counselor coordinator position may involve lifting up to 25 pounds. Travel to outlying clinic sites may be required. Travel may also be required to participate in initial train-the-trainer and continuing education events. The breastfeeding peer counselor coordinator is responsible to the WIC Coordinator of the local employing agency.

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Participant Centered Services: Try using the following language when working with non-breastfeeding women this week: Some moms feel they need supplements after pregnancy. Although the human body is amazing and supplements are rarely needed, it’s good to know what supplements you might be taking so we can check how they might impact your health. Are you taking any supplements?

Customer Service: Use positive and assertive language to create a positive perception. Instead of: "I don't know" use "Let me find out for you"

Breastfeeding:

Given the widespread advantages of breastfeeding, it is the optimal feeding method for healthy newborns. However, there are a few situations where breastfeeding is not recommended.

For infants, these include:

Galactosemia- a rare genetic metabolic disorder where baby cannot digest galactose (special formula that is galactose-free is needed)

Maple syrup urine disease (a special formula free of leucine, isoleucine and valine is needed)

Phenylketonuria or PKU (some breastfeeding is possible under careful observation by a physician; a special phenylalanine-free formula will also be needed)

For mothers, these include:

HIV positive

Untreated, active tuberculosis

Human T-cell lymph tropic virus

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Illegal drugs use

Undergoing radiation therapies

Taking cancer chemotherapy

Herpes simplex lesions on a breast

A small number of medications

WIC Thank you of the Week:

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eWIC Update: Update on eWIC Rollout Nationwide

Below is the nationwide status of eWIC implementation as of June, 2018.

Trainings & Meetings

2018 Dates August 28, 2018 – WIC Contractor Meeting August 30, 2018 – Infant/Child Core Training October 24, 2018 – Communication and Rapport Core Training NETC Meetings July: NETC Go-To-Meeting (All new staff) – July 12, 8:30-11:30 NETC Go-To-Meeting (Health Professional) – July 19, 8:30- 11:30 NETC Go-To-Meeting (Support Staff) – July 26, 8:30-11:30 September: NETC Go-To-Meeting (All new staff) – September 13, 8:30-11:30

NETC Go-To-Meeting (Health Professional) – September 20, 8:30-11:30

NETC Go-To-Meeting (Support Staff) – September 27, 8:30-11:30

November: NETC Go-To-Meeting (All new staff) – November 8, 8:30-11:30 NETC Go-To-Meeting (Health Professional) – November 14, 8:30- 11:30 NETC Go-To-Meeting (Support Staff) – November 15, from 8:30-11:30

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Upcoming NWA Webinars

Upcoming NWA Webinars

You asked, we listened. We have increased the number of webinars so we can best serve all of our members. We encourage you to register for our upcoming webinars.

Important: To attend these NWA webinars, you must register in advance. The links below take you directly to registration. Upon completing your registration, you will receive a confirmation email. If you don't see that email, please check your spam/junk mail folder. We strongly recommend you add sqldba@icohere.com to your email safe senders list to be sure you get your confirmation and other important emails about the webinar.

NWA Webinars

Addressing Perinatal Depression and Anxiety webinar on Tuesday, July 17th at 3:00 pm ET, sponsored by NWA’s Local Agency Section. Moms’ Mental Health Matters (MMHM), an initiative of the NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), aims to raise awareness of depression and anxiety during and after pregnancy, the signs of these conditions, and the importance of getting help. MMHM was shaped by the latest research on perinatal depression and anxiety and by candid discussions with moms and partners who have experienced these conditions around pregnancy.

Engaging Families in Healthy Active Living webinar on July 26th at 3:00 pm ET. Early childhood settings such as child care and Head Start support healthy habits in centers, however, many staff and professionals struggle to engage families to continue healthy habits at home. This webinar will provide an overview of target healthy behaviors for children birth to 5 and strategies for encouraging families to incorporate healthy eating and nutrition habits at home.

Evaluation of DC’s Pilot BfedDC Text Messaging Program on Breastfeeding Behaviors webinar on August 2nd at 3:00 pm ET. To address the lower than average breastfeeding (BF) rates among DC WIC recipients, DC WIC implemented a mobile-health, text-messaging program with 2-way texting capacity, BfedDC. The aim of this study was to evaluate the impact of the pilot BfedDC program on breastfeeding. Join this webinar to hear how DC implemented and evaluated the program. By the end of the webinar attendees will be able to define the components of a text messaging peer counselor program (BfedDC) to promote breastfeeding among WIC mothers and the implications of timing of enrollment; explain the possible pathways by which confounders, including demographics and location of birth, may impact BF outcomes and displace the effect of BfedDC; and describe the importance of using rigorous evaluation methods to understand the impact of the program and to improve program outcomes.

What's Normal in Breastfeeding: What We Can Learn from Research webinar on August 9th at 3:00 pm ET. Highlighting the research from the University of Western Australia, the focus of this webinar is to provide an overview of normal breastfeeding behaviors. The published findings of Dr. Jacqueline Kent describing behavior such as feeding frequencies, day time versus night time feeding patterns, differences between male and female infant feeding patterns, feeding volumes, length of feeding sessions, twenty-four hour milk production volumes and extended breastfeeding.

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Within and Outside the WIC Clinic: Collaboration to Promote Breastfeeding-Friendly Environments webinar on August 16th at 3:00 pm ET. This webinar will discuss the importance of breastfeeding initiatives on the individual and policies, systems and environmental levels; describe ways in which Minnesota WIC supports and promotes breastfeeding for participants and staff; describe community partnerships which can improve support for breastfeeding outside the WIC environment; and discuss how mentoring of students can strengthen breastfeeding support efforts within and outside of WIC.

Improving Nurse Breastfeeding Knowledge with a Hands-On Learning Intervention webinar on August 23rd at 3:00 pm ET. The webinar will discuss the results of a study created to evaluate the effectiveness of hands-on learning to improve nurse breastfeeding knowledge. The intervention was adapted from a WIC training platform that consisted of six participatory breastfeeding stations taught by nurse peers. Nurses completed a pretest assessment of breastfeeding knowledge before the training, and the same posttest assessment after the training. Differences in pretest and post test scores differed significantly, reflecting an improvement in nurse breastfeeding knowledge. Attendees will be able to describe the efficacy of learners doing rather than just hearing and identify at least two new interactive teaching tools to utilize with staff for breastfeeding training purposes.

Workplace Breastfeeding Laws & WIC’s Role in Supporting Breastfeeding Employees webinar on August 30th at 3:00 pm ET. Returning to work is challenging for breastfeeding mothers, often resulting in earlier than intended weaning. Workplace support is critical for the success of breastfeeding employees. This session will cover the changing landscape of workplace laws for breastfeeding employees, including recent legal rulings broadening the Pregnancy Discrimination Act to include lactation. State laws will also be addressed. We will explore WIC’s role in advocating for breastfeeding mothers who may be experiencing difficulties receiving the accommodations they are entitled to. Kansas WIC partnered with the Kansas Breastfeeding Coalition (KBC) to provide education to WIC staff about how to advocate for breastfeeding employees. A referral system was created to provide a warm hand-off to the KBC for challenging cases. The Kansas WIC education and referral system can be easily replicated in other states with state programs with the capacity to assist with workplace advocacy efforts.

Streamlining WIC Certifications webinar on September 11th at 3:00pm ET. Learn about concrete steps WIC agencies have taken to make certification simpler for applicants and staff. Over the last year, eight state and local WIC agencies have implemented action plans to streamline WIC certifications, with technical assistance from the Center on Budget and Policy Priorities and the Altarum Institute. Hear their experiences with making changes such as encouraging applicants to provide electronic documents or completing certification steps before the appointment.

Impact of Baby Friendly Hospital Initiative (BFHI) in Maryland on Selected WIC Agency Breastfeeding Rates and Maternal Experiences of Breastfeeding Support webinar on September 13th at 3:00 pm ET. As of 2010, no hospitals in Maryland were designated as Baby Friendly Hospitals (BFH). Being designated as a BFH confirms that a hospital has implemented the UNICEF/WHO Ten Steps Three hospitals in Maryland received Baby Friendly Certification in 2017. Each of these hospitals have a local WIC agency whose participants primarily deliver at that hospital. This study examines the impact of BFH status on mothers’ experiences with hospital infant feeding practices and postpartum breastfeeding support using a brief postpartum telephone survey with WIC participants (1-3 months postpartum) recruited from the three local WIC Agencies delivering at a BFH hospital and three local WIC agencies delivering at a non-BFH hospital. We will compare reports of receipt of breastfeeding supportive steps by WIC

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mothers in both settings. The results from this study will inform service provision and policy to address breastfeeding inequities.

Getting 5 year old WIC children ready for Kindergarten webinar on October 4th at 3:00 pm ET, sponsored by NWA’s Local Agency Section. WIC is an ideal place to engage young parents to optimize the development and school readiness of young children. It is clear from current research that significant differences exist in children’s exposure to language-rich environments. Children born into poverty hear 30 million fewer words before they reach kindergarten than those who come from middle and higher income families. Because of this gap, children born into poorer families tend to test lower on school readiness scores than their higher income counterparts. This disparity develops before kids are even five years old and the gap continues throughout life. By pairing school readiness messages with WIC services from pregnancy through early childhood, children can graduate from WIC at age 5 ready for Kindergarten. This webinar will discuss the Little by Little Program, and the impact it is making on our WIC children!

New Research Unveils What WIC Infant and Young Children are eating: 2016 Feeding Infants and Toddler Study (FITS) webinar on November 13th, at 3:00 pm ET. Some noteworthy success has been achieved in dietary patterns since 2008; however, additional progress is needed to ensure infants and young children are receiving optimal nutrition for growth and development. This new FITS data offers unique evidence on the impact of the revised WIC food packages and is particularly relevant for the WIC Staff who are on the front line engaging and inspiring families to make healthy eating choices.

WIC Nutrition Assessment Practices webinar on December 11th at 3:00pm ET. Nutrition Assessment in WIC is a delicate balancing act of sometimes competing priorities. Staff are often instructed to be thorough but build rapport, collect accurate data but use conversational assessment, provide education but only after a complete assessment and identify all applicable risk factors but don't overwhelm the participant with nutrition education. It can get complicated! Join this webinar for an interactive opportunity to explore pitfalls and best practices in WIC Nutrition Assessment Practices.

Missed a webinar? Check out our Webinar Archives tab in the NWA online community for all past webinars. Need help accessing the online community? Email webinars@nwica.org.

NWA's mission: The National WIC Association provides its members with tools and leadership to expand and sustain effective nutrition services for mothers and young children.

NATIONAL WIC ASSOCIATION 2001 S Street, NW Suite 580

Washington, DC 20009 Voice: 202–232–5492 | Fax: 202–387–5281

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Available Formula

Product Quantity Exp. Date Agency Contact

Enfaport 57 bottles 8-1-2018 HACAP Brenda Meshak

(319) 366-7632

Ensure Clear

Apple Flavor 8 fluid oz.

22 cartons 12-1-2018 Broadlawns WIC/Lutheran Rose Logan

515-263-5621

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies,

offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have

speech disabilities may contact USDA through the Federal Relay Service at (800) 877- 8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form (AD- 3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632- 9992. Submit your completed form or letter to USDA by:

Mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington,D.C.20250-9410

Fax: (202) 690-7442; or E-mail:program.intake@usda.gov This institution is an equal opportunity provider.