Elements of a Successful

BreastfeedingProgramSan Marcos, California

760-752-4324

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 IBCLC10 CLE’s and 6 more in training

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!

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.

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.

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).

Our Study PopulationIntervention N

=86Control N = 92

Ethnicity Hispanic = 75 (87%) Hispanic 79(85%)

Primary Language Spanish = 59 (69%) Spanish = N/A

Prior Experience Breast Feeding

42 (49%) N/A

Calls Made Within First 14 days

62 (73%) N/A

Average Age of Infant at Second Call

22 days old N/A

Average Age of Infant at Enrollment

Appointment

20 days old 16 days old

We Made a Difference!

Age at which 25% are still Exclusively Breastfeeding (or Excl. BF w/solids)

315 days old(10 ½ months)

194 days old(6½ months)

Statistically Significant at .05

Intervention Control

Breastfeeding Exclusively at First month

72/86 (84%) 68/92 (74%)

Breastfeeding Exclusively at Second month

49/86 (58%) 45/92 (42%)

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.

Conclusion

Early phone intervention helped the group of mothers have a better breastfeeding experience, and prevented them from quitting prematurely.

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.

NCHS WIC ProgramPolicies

and Procedures