Elements of a Successful Breastfeeding Program San Marcos, California 760-752-4324

2. Elements of a Successful Breastfeeding Program San Marcos, California 760-752-4324

3. NCHS WIC Agency Profile • 5 permanent sites and 3 satellite clinics throughout Northern San Diego County. • 35 Full and Part Time Staff. • Participation: 10,654 (2/08) • English 41.5%, Spanish 57.8% and <1% other Languages. • Number of Infants: 2358 (2/08) • 1 Part-time IBCLC • 10 CLE’s and 6 more in training

4. Staff Training, Pump Loan and Other Elements • Extensive Staff Training • Yearly in-house trainings for all other staff. • Thorough training for new staff. • Brought CLE training to our agency. • Breast Pump Loan Program • Over 200 electric breast Pumps to lend. • Breastfeeding Friendly Environment • Referral Systems • WIC staff can refer complex BF problems to the CLE or IBCLC. • NCHS providers refer BF problems back to WIC. • Breastfeeding promotion is everyone’s job!

5. Comprehensive Participant Education and Support • Two prenatal breastfeeding classes. • A “Why To BF” and a “How To BF”. • All prenatal ppts. are made aware of our “No formula in the first month” policy. • Early post-partum BF support phone calls to ALL new mothers. • Breastfeeding Warm-Line for ppts to call with questions. • Breastfeeding support groups.

6. No Formula in the First Month • Set a date 9 months in advance to start policy. • Begin with extensive staff training, so all are comfortable discussing and supporting breastfeeding. • Start telling all pregnant women at enrollments, trimester checks and classes that WIC doesn’t routinely give formula to breastfed babies less than one month old. • Enroll baby then recertify post partum mother the following month, so they receive two contacts of BF support. • If they want to combo feed, tell them they can after exclusively breastfeeding for the first month. • We find after they get through the first month, they often don’t need the formula in the second month. • Formula is only given in extenuating circumstances with supervisor approval.

7. Early Postpartum Phone Call Study • Hypothesis: WIC mothers who received an early postpartum phone call to offer BF support will be more likely to exclusively breastfeed and breastfeed for a longer period of time than a control group. • Babies born to NCHS WIC from 10/03 and 11/03 were in study and FI’s were followed for a year. • Half received phone calls (intervention) and half did not (control).

8. Our Study Population

9. We Made a Difference! Statistically Significant at .05

10. Why it Worked Connected with Mothers at their time of need • The calls were beyond the normal WIC “clinic” services • They were reached at a “vulnerable” time in breastfeeding. Mothers had 100% of our attention, • Staff were given time to make call, build rapport with women. • The intervention was individual and personal. Well-trained staff • Open ended & closed questions were asked that allowed us to educate, guide and reassure. • WIC is a trusted resource.

11. Conclusion • Early phone intervention helped the group of mothers have a better breastfeeding experience, and prevented them from quittingprematurely. • Using early postpartum phone intervention calls, we increased breastfeeding exclusivity and duration. • Early postpartum phone intervention fits within the “scope of WIC services”. • The calls could be easily replicated in other settings.

12. NCHS WIC Program Policies and Procedures