MotherBaby Network

advocacy and commentary with a focus on Lane County, Oregon

OR WIC Invests in Breastfeeding – Hires Cottage Grove Breastfeeding Consultant

Desiree Nelson, RN, IBCLC recently accepted a temporary project coordinator position with Oregon Women, Infants and Children (WIC). Nelson’s hire fits within WIC’s plan to support implementation of evidence-based breastfeeding practices in hospitals. WIC is a public health program designed to improve health outcomes and influence lifetime nutrition and health behaviors in a targeted, at-risk population. Building on the state’s already-high rates of initiation (90.4%), WIC aims to support providers and facilities to adopt the practices known to positively influence rates of exclusive breastfeeding inside Oregon hospitals.

Nelson’s position is funded with a porti on of the $300,000 in “USDA breastfeeding bonus funds” recently received from the federal government. Selected for its high rate of breastfeeding initiation, Oregon is one of five states to be awarded the bonus funds. They must be spent by September 2010.

WIC’s goal to increase exclusive breastfeeding rates is consistent with the Healthy People 2020’s national breastfeeding objectives to maximize maternal and infant health as well as with the White House Task Force on Childhood Obesity’s new report which includes recommendations to support evidence-based breastfeeding support. It is also in line with new requirements by the Joint Commission, the nation’s leading hospital accrediting agency, to maximize the number of women exclusively breastfeeding at hospital discharge.

A long-time Lane County resident, Nelson brings nearly three decades experience in advocating for and providing proper lactation support to families. She played a leading role in Cottage Grove Community Hospital earning the Baby Friendly Hospital Initiative (BFHI) designation. She also worked closely with the PeaceHealth Nurse Midwifery Birth Center to achieve the BFHI designation. Most recently, she  co-founded Baby Connection, a demonstration project providing free, drop-in evidence-based infant feeding education and peer support. Operating at maximum capacity every week, Baby Connection fulfills BFHI’s step 10 to provide support groups that women can access after hospital discharge.

BFHI facilities meet the highest standard for evidence-based mother- and baby-friendly breastfeeding care. Unfortunately, the Cottage Grove Community Hospital lost its designation in 1998, leaving the PeaceHealth Nurse Midwifery Birth Center as the sole BFHI-designated facility in the county.

In Nelson’s capacity as a WIC project coordinator, she will:

  1. Provide technical assistance to interested hospital lactation and administrative staff to improve breastfeeding outcomes, including applying for the Baby Friendly Hospital Initiative designation.
  1. Assist local WIC agencies to strengthen collaboration with hospitals and health care providers serving their participants.

Toward this end, two regional conferences, in Deschutes and Lane Counties, will be convened. For more information, contact Nelson at desiree.ann.nelson@gmail.com

Breastfeeding improves health outcomes, saving lives and resources

The journal Pediatrics recently published an analysis estimating more than 900 babies and $13 billion dollars would be saved annually, if 90 percent of U.S. women exclusively breastfed for the first six months of a child’s life. The Register-Guard ran an Associated Press story on the findings.

WIC’s focus on hospital-based care is spot on. Hospital practice sets the course for breastfeeding exclusivity and duration. In the absence of comprehensive evidence-based care, women and infants’ efforts are undermined – most often through non-medically indicated interventions including formula feeding. Formula use in the early days of an infant’s life interferes with mastering latching and suckling, which are critical in establishing a woman’s adequate milk supply. Even though nine of ten Oregon women arrive at the hospital preferring to breastfeed, most are unaware of the consequences standard lactation practices can have for breastfeeding. Without intending to, many women and families leave the hospital well on the way to weaning.

The recent Oregon WIC Peer Counseling Research Project, a multi-year peer counselor breastfeeding study with 1,695 mothers from diverse regions of the state confirms the potency of hospital-based formula introduction to hamstring breastfeeding. One-third of participants introduced formula within the first few days of their baby’s life. Women most frequently reported being given formula because their milk had not come in. Breast milk does not come in immediately rather women produce colostrum first. The fact that women are encouraged to supplement with formula for “milk not coming in” reflects a critical lack of evidenced-based breastfeeding management skills among healthcare providers to new mothers.

Baby-Friendly Hospitals Needed in Lane County

Hospitals serious about maternal and child health join the nation’s 88 world-class leaders in breastfeeding excellence by becoming a designated Baby-Friendly Hospital or Birth Center. Neither Sacred Heart Medical Center (SHMC) nor McKenzie-Willamette Medical Center, Lane County’s leading hospitals, is on this list. The PeaceHealth Nurse Midwifery Birth Center is.

Baby-Friendly facilities ensure all women receive comprehensive evidence-based service. They have codified policies requiring all staff, from nurses’ aides to doctors, who are in contact with mothers be trained to assist and assess initiation. Assessing can mean knowing when to call in a lactation consultant. Women and their support network learn about breastfeeding during pregnancy, receive 24-hour lactation support after discharge and access to on-going, non-emergent expert and peer support throughout the first year postpartum.

Ensuring women go home with a good latch and access to a 24-hr hotline solves innumerable breastfeeding problems before they balloon into crises. Early, unaddressed breastfeeding challenges can dog a woman throughout breastfeeding.

Baby-Friendly signifies a shift in cultural milieu and norms. It does not mean saying “no” to a mother who prefers to formula feed.  This rationale is often used to dodge serious discussion of improving facility practice. Baby-Friendly means, for example, that mothers are not encouraged to use formula or pacifiers, both of which wreak havoc with sound initiation, for non-medical reasons or without an understanding of the risk they pose to initiation. It also means hospitals stop accepting free gifts, including formula, from manufacturers.

WIC’s commitment to evidence-based breastfeeding care provides important resources to local hospitals for transforming current practice into best practice, consistent with national objectives. For more information, Desiree Nelson can be contacted at desiree.ann.nelson@gmail.com.

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