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A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S

A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S

A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S

Children’s Healthy Weight CoIIN

Wednesday, July 17, 2019

A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S

Breastfeeding Workstream Projects

Arkansas California Iowa Louisiana Nevada North Dakota Wisconsin

Arkansas's Children’s Healthy Weight CoIIN

Project Background

• According to the Surgeon Generals Call to Action Report, 75% of US mother will start
• ut motherhood breastfeeding with 13% of babies being only breastfed by 6 months
• f age. These rates are drastically lower in African American babies.
• The purpose of Arkansas's Children’s Healthy Weight CoIIN project is to support

breastfeeding mothers who have limited access to health care by conducting lactation accommodation training for up to 10 organizations in Arkansas’s Southeast/ Delta region and other at-risk communities so that employers and communities learn, engage, and practice the support lactating women and change procedures/ policies to provide accommodations.

• Arkansas aims to increase the duration and exclusivity of breastfeeding in

intervention sites by allowing adequate space and time to pump, breastfeed, and store milk in the workplace. These advancements will begin to initiate a change in perception in culture and in communities where breastfeeding has not traditionally been accepted as a social norm. Objectives

• 1. Create up to 10 breastfeeding Rooms/Nooks in early childcare centers (ECE) in the

delta region of Arkansas

• 2. Create Policy, System and Environmental changes in up to 10 breastfeeding

rooms/nooks in early childcare centers in the delta region of the state.

• 3. Train ECE staff on Arkansas laws protecting a woman’s right to breastfeed/express

Successes

Before After

**testimonial**

Challenges

• Gaining entrée into communities
• Arranging time for pre/post CDC Scorecard

Key Lessons Learned

• Identify ‘champions’ as early in the process as

possible

• Trust the process

Reducing Breastfeeding Disparities in California Through Lactation Accommodation

Project Background

• The CoIIN was an extended effort

to support our existing statewide low-wage lactation accommodation work group.

• Several strategies were selected

to advance lactation accommodation including: webinars, social media campaign, conference presentations and an issue brief.

Successes

• Interest in learning about or

improving lactation accommodation was evident in: – Webinar attendance – Social media skills building – Conference workshop attendance – Partnership with multiple

• rganizations to address

lactation accommodation

• utside the scope of the

CoIIN

Challenges

• State and federal lactation

laws can be confusing. Lots of learning opportunities are needed to understand the laws, including for lactation experts.

• Personal inexperience, or

disallowance by employers, of breastfeeding experts to use various social media

• Webinar technicalities for

analytics

Key Lessons Learned

• Employ multiple strategies to

engage a wide audience.

• Each strategy fits into a long-

range plan to improve systems and policies.

• Educational opportunities are

needed to support more use of social media by breastfeeding experts.

• For educational events allow lots
• f time for discussion and provide

case management examples.

• Building partnership with diverse
• rganizations fortifies the

strategies.

Iowa

CHILDREN’S HEALTHY WEIGHT COIIN

Project Background

u Reviving the MCH/WIC partnership was

desired

u Breastfeeding rates can always improve u Iowa has a very high rate of moms

returning to work after having a baby

u Health equity focus at Iowa Department

• f Public Health

Successes

u Developed an infographic and poster regarding

workplace breastfeeding rights for WIC and Title V Programs

u Sponsored Breastfeeding Basics for Childcare

Providers train-the-trainer for Child Care Nurse Consultants to improve breastfeeding support for in childcare

u Supported 3 minority women to attend Certified

Lactation Counselor/Specialist training

u Developed an breastfeeding-friendly, statewide WIC

breast pump issuance policy to be rolled out in Oct 2019

u In process of enhancing a referral process for utilizing

Title V billing codes for extended breastfeeding education/support between WIC and MCH

Challenges

u Lack of funding for staff time u Scheduling team meetings/busy schedules u Timeline for changes- Government shutdown delayed WIC

pump policy pilot

u Finding minority women with time available/interest for

extended breastfeeding training

Key Lessons Learned

u Be open to change/willing to

adapt

u Planning far in advance is

beneficial for group work

u Utilize your available resources u Change takes time

Louisiana

Project Background

• Est. 2007 in few

communities 2012 Kellogg funding – focus

• n New Orleans,

but planned for spread 2014 Well- Ahead included BF as WellSpot benchmark

Successes

Challenges

• Diversification of our Lactation

Accommodations Statewide Work Group

• Team capacity

Key Lessons Learned

• Start small
• Be patient
• Be persistent
• Partnerships are key

State of Nevada WIC Program

Breastfeeding Partner Support Project July 2019

Project Background

Nevada WIC is incorporating partner support into education materials, the WIC clinic setting, and the community as a whole. To protect and support breastfeeding, work to include partners in breastfeeding education to improve rates statewide. Substantial evidence demonstrates the importance of partner support when women determine whether to initiate or to continue breastfeeding.

Successes

§ Held a pilot Father’s Day

event to gather information from the community.

§ Follow-up event planned in

August.

§ Received Nurturing Father’s

Training July 10-12, 2019 to gain information on how to better engage partners.

§ Working towards making

clinics more inclusive of partners, dads, grandparents, etc.

Challenges

• Unexpected loss of team members
• ver course of project.
• Reaching dads, fathers groups to

promote efforts and participate.

• Weekdays worked better for outreach.
• Need for father groups, information on WIC benefits/eligibility

, child care, education, etc.

• Promote events through father-centered agencies, community partners.
• Incentives helpful to get partners to the clinic to participate.

Thank you!

Jacquelyn Bonde, MPH, CLE Team Lead Nevada WIC E: jbonde@health.nv.gov P: (775) 684-3473

North Dakota

Project Background

Successes

• 2017-2018: Key stakeholder meeting with four
• f the five tribal communities and two of the

three ND communities with urban American Indian populations engaged.

• 2018-2019: Five grants awarded to four

communities to establish new policies or practices addressing barriers to breastfeeding in American Indian communities.

Challenges

• Too narrow of a focus in the beginning of the

CoIIN (Indigenous Breastfeeding Counselor Training) without input/needs assessment from the communities.

• Did not define role of CoIIN and how best this

fit in American Indian communities to help them meet their goals.

Key Lessons Learned

• Relationship building is key and takes time.
• Be clear and define up front mutual

expectations.

Wisconsin

Breastfeeding

Project Background

2018

– Need for funding to support the creation of lactation spaces.

• 10 mini grants to improve lactation services and policies within workplaces

and to address disparities in lactation support offered to women of various backgrounds and experiences.

– Launched this initiative during Breastfeeding Week. The mini grant application asked applicants to describe how the project would promote and/or support breastfeeding among employees, especially among groups of women who may be less likely to breastfeed their infants.

• Examples included: creating/improving a dedicated lactation room (space,

chair, table, artwork, printed materials, lock changes), and developing/ providing educational materials in multiple languages.

– A lactation policy was a requirement of the project.

• The applicant was required to be working with a local or tribal health

department for support with the lactation policy and creation of the lactation space or support materials.

Project Background

2019

• Expanded the number of mini grants offered to 12 at the same

funding level of $250.

– Based on results from our PDSA cycles, we strengthened language within the application to ensure that the mini grants would benefit populations that typically have breastfeeding disparities.

• Questions addressed by current PDSA cycles

– Does adding information on demographic disparities in breastfeeding rates to mini grant application increase the number of underserved populations identified as targeted in the applications? – Does offering more time for 2019 mini grant application promotion and completion result in more eligible applications being submitted?

Successes

2019

• PDSA cycle testing whether longer application

time would result in additional applications for lactation spaces minigrants.

– We predicted the longer time would result in 15 applications, 5 more than last year. We actually received 25!

Challenges

• Ensuring mini grant applications intentionally

address targeted populations experiencing breastfeeding disparities.

– Our PDSA cycle including demographic data in the RFA did not result in additional applications with these populations identified.

• Scoping innovative nutrition work

– Slow start to these efforts

Key Lessons Learned

• Working with partners is essential!

– The nutrition driver may promote connection with new partners.

• Creating a core team at DHS provided

consistent expertise for the CoIIN

• Creating an ad hoc Worksite Committee

including local and tribal representation provided a valuable resource to complete goals.

A S S O C I A T I O N O F S T A T E P U B L I C H E A L T H N U T R I T I O N I S T S

Upcoming events

✔ July 31, 2019 at 3:00 pm ET - Physical Activity Workstream Networking Call ✔ August 21, 2019 at 1 pm ET – All Workstream Webinar – Physical Activity Workstream Projects