Implementing Best Practices for Breastfeeding Promotion

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(No Transcript)
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Communities Working Together to Promote
Breastfeeding

• Mary Applegate, MD MPH
• Bureau of Womens Health
• NYS Department of Health

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Breastfeeding is one of the simplest, most
cost-effective ways to promote good health during
infancy.

• Communities Working Together for a
• Healthier New York

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Blueprint for Action on Breastfeeding

• US Department of Health Human Services
• 2000

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Why breastfeeding?

• Infant health
• Maternal health
• Convenience
• Economic benefits

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Infant health

• Optimal nutrition, including for premies
• Growth development
• Maternal bonding, comfort
• Disease prevention
• Infections
• Allergies
• Chronic diseases
• SIDS

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Maternal health

• Postpartum recovery
• Birth spacing
• Psychological benefits
• Disease prevention
• Breast cancer
• Uterine ovarian cancer

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Convenience

• Always the right temperature
• Sterile
• Portable

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Economic benefits

• Cost of formula and related paraphernalia
• Health care costs
• Doctor visits
• Pharmacy
• Hospitalizations
• Less time lost from work other responsibilities

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Healthy People 2010 goals

• 75 early postpartum
• 50 at 6 months
• 25 at 1 year

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New York Stats
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Variation within New York

• By region 56.3 to 75.8
• By hospital 28.6 to 95.5
• 26 hospitals exceed Healthy People 2010 goal
• By socio-economic status
• 67.3 population-wide
• 50 among WIC participants

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Reasons for variation

• Cultural attitudes
• Family community support
• Healthcare provider policies practices
• Employment status support

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Cultural attitudes

• Most challenging . . . most important to
  change

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Cultural attitudes 1
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Cultural attitudes 2
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Changing attitudes

• Community education
• Breastfeeding First Step to Good Health
  -- K-12 Learning Activities
• http//www.health.state.ny.us/nysdoh/b_feed/index.
  htm
• NYS Civil Rights Law

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Breastfeeding First Step...

• Develop positive attitude toward breastfeeding,
  starting in early grades

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Breastfeeding First step...

• In older grades, learn about breastfeeding
• biological facts
• environmental economic benefits
• choices decision making . . .

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NYS Civil Rights LawNotwithstanding any other
provision of law, a mother may breast feed her
baby in any location, public or private, where
the mother is otherwise authorized to be,
irrespective of whether or not the nipple of the
mothers breast is covered during or incidental
to the breast feeding.
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Reasons for variation

• Cultural attitudes
• Family community support
• Healthcare provider policies practices
• Employment status support

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Family community support

• Warm chain for breastfeeding
• Family, friends, child care providers supportive
  knowledgeable -- regardless of personal
  experiences
• Community support services
• La Leche League
• WIC peer counselors
• Nursing Mothers Counselors

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Health care practices

• New York State Hospital Code
• Best Practices for Breastfeeding Support
• Hospital
• Managed care
• Outpatient clinics

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Hospital support

• Lactation coordinator
• Encourage breastfeeding in delivery room
  24-hour rooming-in
• Avoid supplemental formula, water, bottles,
  pacifiers
• Educate mother about key issues
• Ensure availability of follow-up

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Managed care support

• Monitor breastfeeding rates
• Encourage obstetric pediatric providers to
  promote support breastfeeding
• Include in benefit package
• Breastfeeding classes
• Lactation consultant visits
• Rental of hospital grade pump if mother newborn
  are separated (e.g. premie in NICU)

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Ambulatory care support

• Positive staff attitudes
• Inviting waiting room
• Lactation specialist on staff
• Breastfeeding classes on-site
• Appropriate resource material
• Breastfeeding warm line
• No formula company material
• Breastfeeding assessed at each pediatric visit
• Duration of breastfeeding monitored

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Workplace support

• Maternity leave -- 6 weeks or more
• Allow infant to be near mother
  (in office on-site childcare)
• Flexible schedules
• Breastfeeding or pumping breaks
• Lactation room -- pump, chair, fridge
• Lactation consultant
• Breastfeeding classes

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Childcare support

• Positive staff attitudes
• Policies supportive of feeding expressed
  breastmilk and/or having mother visit to
  breastfeed
• Information about combining working
  breastfeeding
• Suggestions for working with employer

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Partners in promotingbreastfeeding

• Physicians, midwives, nurses
• Lactation consultants
• Hospital lactation coordinators
• WIC staff peer counselors
• La Leche League, community groups
• Employers/businesses
• Schools, childcare centers

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Breastfeeding is one of the simplest, most
cost-effective ways to promote good health during
infancy.

• Communities Working Together for a
• Healthier New York

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