Happenings. Washington State Hospitals Enhance Breastfeeding Support

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1 Happenings Sept , Breastfeeding and Lactation: A Five-Day Course, Spokane, WA. Karen@pqproducts.com Sept. 16, Building Upon the Science: New Modalities in Supporting the Breastfeeding Dyad, Kenmore, WA. Sept , Fundamentals in Lactation, Port Orchard, WA. Oct. 6-7, Teaching Baby Behavior: A Train-the-Trainer Conference for Professionals, Davis, CA. www. lactation.ucdavis.edu/conferences/ teachingbabybehavior2011.html Oct. 3-7, Professional Education in Breastfeeding and Lactation. Kenmore, WA. akennedy@bastyr.edu Oct , Promoting Excellence in Perinatal and Neonatal Care, Spokane Valley, WA. Nov. 4-5, Understanding Lactation: A Work in Progress. Berkeley, CA. Vol 9 # 1 Vol. 13, No. 2 Summer Summer Washington State Hospitals Enhance Breastfeeding Support Hospital breastfeeding support has been making headlines lately. The recent release of the Centers for Disease Control and Prevention (CDC s) 2009 Maternity Care Practices in Infant Nutrition and Care (mpinc) survey results show that hospitals in Washington State are taking important steps to ensure that perinatal breastfeeding support for new families is evidence-based. Ranking ninth in the country in 2007, the 2009 results show that Washington State hospitals have moved up to rank seventh among all states. Ninetyone percent of eligible hospital and freestanding birth centers in Washington responded to the CDC s call. Earlier this month, the CDC also released the report, Vital Signs: Hospital Support for Breastfeeding. The findings from this report, which note that most hospitals in the U.S. do not fully support breastfeeding, are based on national results from the 2007 and 2009 mpinc surveys. What is the mpinc? As of 2007, the CDC conducts the national mpinc survey every two years to assess changes in hospital maternity care practices. The survey is sent to every U.S. facility that provides maternity care services. The CDC compiles each responding facility s data into a Benchmark Report which is intended for use as an intervention strategy developed to raise awareness, provide motivators for change, and identify barriers to change that are specific to the facility. Based on the individual surveys, the CDC also compiles state and national reports. The mpinc survey was designed to promote positive change within birthing facilities by encouraging these facilities to follow evidence based guidelines to fully support breastfeeding families. New mothers are faced with many challenges and barriers to meeting their breastfeeding goals and research shows that hospital maternity care practices greatly influence the successful initiation and subsequent exclusivity and duration of breastfeeding. By adhering to the Ten Steps to Successful Breastfeeding, an evidence based set of hospital practices established by the World Health Organization and United Nations Children s Fund (and what the mpinc survey is based on), hospitals are better equipped cont. on page 6, see Hospitals

2 Anne Montgomery, MD, FAAFP, FABM, IBCLC Eastern Region Chair, BCW Silje Sodal, MPH Outgoing Western Region Chair, BCW BCW Steering Committee members and allies at the 2011 Awards. Jean O Leary, MPH, RD WIC Breastfeeding Coordinator, Department of Health Patty Hayes, RN, MN Executive Director, WithinReach Rachel Schwartz, MSW, MPH Program Manager, BCW The Breastfeeding Coalition of Washington (BCW) is a program of WithinReach and works to promote, protect and support breastfeeding as a vital part of the health and development of children and their families. The BCW includes over 20 local breastfeeding coalitions across the state. Breastfeeding Matters is published electronically three times a year by WithinReach, 155 NE 100th St, Suite 500, Seattle, WA The goal of this publication is to provide information and networking specific to the needs of those promoting breastfeeding. BCW and WithinReach do not accept responsibility for the application of any information to individual medical conditions where consultation with a health care provider is needed. The Breastfeeding Coalition of Washington is a program of WithinReach and is supported by Washington State Department of Health. Funds for this newsletter are provided by the Washington State WIC Program. The Washington State WIC Program is an equal opportunity provider and employer. To view back issues and to receive this electronic newsletter go to: If you have questions about the BCW or this newsletter, or would like to suggest an article for inclusion in a future newsletter, please contact: The Breastfeeding Coalition of Washington 155 NE 100th St, Suite 500 Seattle, WA Telephone: breastfeedingcoalition@withinreachwa.org BCW Comes Together to Celebrate 2011 Award Recipients On April 20, the Breastfeeding Coalition of Washington held its annual meeting for Steering Committee members and celebrated 2011 BCW Award Recipients with an evening gathering. Over 30 Steering Committee members attended the meeting, representing local coalitions and organizations from across Washington, and participated in a full-day agenda reviewing progress the BCW has made in the past year. Particular focus was paid to the BCW s Maternity Care Practices Initiative and on the Business Case for Breastfeeding. The BCW Steering Committee also performed an inventory of breastfeeding support in Washington State according to the action steps outlined in the Surgeon General s Call to Action to Support Breastfeeding. Coalition members shared success stories and experiences working with local businesses to establish worksite lactation support and provided updates on the work of their local community coalitions. A brainstorming session was also held to generate a list of businesses that commonly employ WIC or WIC-eligible women, to help guide the work of the BCW Worksite Lactation Support program. BCW Acknowledges Community Leaders The 2011 recipient of the BCW Outstanding Employer Award is Clark County. Through the support of employees in their Public Health department, Clark County has established a worksite policy for supporting breastfeeding employees at all county government offices. This policy now also serves as a model for other community businesses in the county for how employers can play a larger role in supporting breastfeeding when moms return to work. Their breastfeeding policy states Clark County is committed to supporting breastfeeding mothers in order to help them make the transition back to work easier, and encourages employees and management to have a positive, accepting attitude toward working women who choose to nurse their infant after returning to work. Public Health has also provided support to the County Human Resources Department to secure lactation spaces at County buildings. In addition, dietitian Elspeth Durek and other Public Health staff are also working with local businesses to promote support for breastfeeding mothers and compliance with new federal regulations. With more than 600 programs and thousands of employees, this policy will clearly have a large impact on the health and well-being of Clark County families. cont. on page 3, see BCW Awards 2

3 BCW Awards... cont. from page 2 Kimberly Radtke Accepts Spirit of Service Award As former Program Manager of the Breastfeeding Coalition of Washington for 12 years, Kimberly Radtke helped establish the BCW, with its network of local community coalitions, as one of the strongest and most active statewide coalitions in the country. In this role to promote, protect and support breastfeeding in Washington State, Kim was steadfast and passionate. BCW Steering Committee members echoed award namesake Nancy Danoff s sentiment that words really can t describe all that Kim has done for mothers, families, the BCW and the greater community. While accepting the 2011 Spirit of Service Award, Kim shared that If we are lucky, we learn a lot from our work and if we are really lucky what we learn helps us in future endeavors. During my time at the BCW, I had numerous opportunities to practice patience, negotiation, collaboration, public relations, communication and of course to improve my clinical knowledge of breastfeeding, all of which have helped me tremendously with my full time focus of being Karson s mom. (L to R): Jean O Leary, WA State Department of Health, Marni Storey, Clark County Public Health Services Manager and Elspeth Durek, Dietitian with the Clark County Public Health Chronic Disease Prevention Unit. Dr. Knox Receives Physician Leadership Award Dr. MaryAnn O Hara, in whose honor the Physician Leadership Award was established, presented this year s award to Dr. Isabella Knox. Dr. Knox is a neonatologist at the University of Washington Medical Center (UWMC), Seattle Children s Hospital, Providence Regional Medical Center in Everett and Overlake Hospital. She is also an associate professor of pediatrics at the UW School of Medicine. Since moving to Washington State from Connecticut, she has established herself as one of the leading physicians in the region who support breastfeeding for her knowledge and treatment of frenotomies, a minor surgical procedure to alleviate ankyloglossia (also known as tongue-tie), a congenital oral anomaly that can often impede a successful breastfeeding relationship between mother and baby. Indeed, staff at UWMC credit Dr. Knox with having brought the concepts of frenotomy and donor milk into discussion at the UWMC neonatology department. Dr. Knox is a member of the Academy of Breastfeeding Medicine, fellow of the American Academy of Pediatrics, a founding member of the International Association of Tongue-Tie Professionals and sits on the Board of the Northwest Mothers Milk Bank. If you would like to nominate someone for a BCW Award, please the BCW Program Manager at breastfeedingcoalition@withinreachwa.org, with an explanation of why you think this person or business is deserving of this recognition Spirit of Service recipient Kimberly Radtke, left, with award namesake, Dr. Nancy Danoff Physician Leadership Award recipient Dr. Isabella Knox, left, with award namesake Dr. MaryAnn O Hara.

4 Pink Meets Green: Big Pink Bus Makes a Stop in the Emerald City The BCW played hometown host in July to Milk for Thought s Big Pink Bus, as their Latch On America tour made its northern most stop in the Pacific Northwest. Earlier this summer Milk for Thought embarked on the 45-day, 30-plus city tour to support, empower and connect breastfeeding communities across the country. With breastfeeding making headlines from the Surgeon General s Call to Action to the First Lady s Let s Move Campaign to a passionate advocacy and support network, Milk for Thought decided to take their work on the road to document the energy, passion and dedication of breastfeeding advocates all over the United States. When the road trip was announced, Milk for Thought founder Ryan Comfort was wowed by the passionate response from breastfeeding supporters in cities and towns across the country from Poughkeepsie to the Navajo Nation to Seattle who rallied to bring the big pink bus to their city. The Latch on America tour started with an initial idea to rent an RV and drive cross country to meet all the amazing supporters and moms who are taking action for the breastfeeding community. Now, because of the excitement and overwhelming response we got, the trip has gotten bigger, 40 feet of pink bus bigger, with stops in more than 30 cities! Comfort said. We were thrilled to welcome the Latch On America Tour to Puget Sound. Washington is home to a very strong, creative breastfeeding community, and we were especially excited to share some of our successful programs and work with the rest of the country, says BCW Program Manager Rachel Schwartz. As part of their stop, Milk for Thought visited the Island County New Baby, New Family program in Coupeville on Whidbey Island and attended a roundtable with several community organizations that provide New moms and representatives from Island County Public Health (ICPH) and the BCW gather together in front of the fabulous ICPH Community and Family Services outreach van. holistic, comprehensive and culturally-relevant health promotion and breastfeeding support for communities of color and immigrants. Organizations that were represented include International Community Health Services, Open Arms Perinatal Services, SeaMar Community Health Centers and the Equal Start Community Coalition. In the afternoon, local breastfeeding coalitions, La Leche League and other support groups and allies gathered around the big pink bus to host a public event at Valley Medical Center in Renton. Families, community members and breastfeeding advocates came to check out the bus, learn more about the many resources available to breastfeeding families, and connect with others. People who live in Seattle are really lucky to have access to the services of so many wonderful organizations, says Comfort. The Seattle gathering event was a great success to highlight this. To learn more about the Latch On America Tour, you can follow Milk for Thought s blog at tour. Members of the South Sound Breastfeeding Network came together at the Latch On America gathering event. Staff from Open Arms Perinatal Services discuss supporting breastfeeding moms at the Community Organization round table. 4

5 Affordable Care Act Ensures Women Receive Preventive Services at No Additional Cost Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced in early August by the U.S. Department of Health and Human Services (HHS). Developed by the independent Institute of Medicine (IOM), the new guidelines require new health insurance plans to cover women s preventive services such as well-woman visits, breastfeeding support, domestic violence screening and contraception without charging a co-payment, coinsurance or a deductible. The IOM s report relied on independent physicians, nurses, scientists, and other experts to make these determinations based on scientific evidence. The Affordable Care Act helps stop health problems before they start, said HHS Secretary Kathleen Sebelius. These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need. Before health reform, too many Americans didn t get the preventive health care they need to stay healthy, avoid or delay the onset of disease, lead productive lives and reduce health care costs. Often because of cost, Americans used preventive services at about half the recommended rate. This new announcement establishes a way for women to have access to a full range of recommended preventive services without cost sharing, including: well-woman visits; breastfeeding support, supplies, and counseling; screening for gestational diabetes; human papillomavirus (HPV) DNA testing for women 30 years and older; FDA-approved contraception methods and contraceptive counseling; domestic violence screening and counseling; sexually-transmitted infection counseling; and human immunodeficiency virus (HIV) screening and counseling. This important announcement is another part of the Obama Administration s broader effort to address the health and well-being of communities through initiatives such as the President s Childhood Obesity Task Force, the First Lady s Let s Move! campaign, the National Quality Strategy and the National Prevention Strategy. For more information on the HHS guidelines for expanding women s preventive services, please visit: womensprevention a.html. The guidelines can be found at: Breastfeeding and the Navy: a Spotlight on Rural Oak Harbor Though community and clinical efforts to support breastfeeding moms are increasing, families on active duty in the military have additional unique challenges when providing their babies with exclusive breastmilk. Here in Washington State, the army, navy and local WIC programs place great importance on supporting breastfeeding moms, whether they are on active duty or their partner is. One such program doing impressive work is the Naval Hospital Oak Harbor (NHOH) located on rural Whidbey Island. Cathleen Stewart, a registered nurse and certified lactation consultant at the Naval Hospital and member of the Whidbey Island Breastfeeding Coalition says, I think the most unique aspect or difficulty about any branch of the military is the separation from their home support system. These young families are not usually near their own families so they may feel isolated, unsure, etc. Fathers might be deployed. Women who give birth at NHOH have a high rate of breast feeding initiation, on the average 85-95% and Stewart notes that the hospital offers inpatient and outpatient support. The Navy Marine Corp Relief Society and the Island County New baby, New Family program also have visiting nurses who do home visits for weight checks and breastfeeding support and encouragement. There is a WIC office on base to offer support to families that qualify and the local La Leche League group is very active. Stewart says, We are working with the different commands on base to help ensure an appropriate space and time for active duty service women so they can pump and provide exclusive breastmilk for their child. I would like to think that we are able to offer the support that families in the Navy need and are missing from their own families and friends. And if I personally can be a part of this special time in their lives and help them to accomplish their breastfeeding goals, then that is my reward. Joint Base Lewis-McChord and the Madigan Healthcare System in Pierce County also have a M.O.M s (Mother s Own Milk) Breastfeeding Support Group that meets regularly. 5

6 Hospitals Takes Steps... cont. from page 1 to support mothers decisions to breastfeed and to increase breastfeeding rates. mpinc Dimensions of Care Between 2007 and 2009, Washington State improved its score in 6 out of the 7 dimensions of care (see graph this page). Strengths of Washington hospitals include consistently asking about and recording mothers infant feeding decisions (97% of surveyed hospitals do), and mothers and babies rooming-in together at night (95% of surveyed hospitals reported doing so). Washington ranks highest in the nation for the percentage of hospitals reporting they do not separate mother-infant pairs during the hospital stay. This report is an encouraging example of how the hard work and commitment of those involved in caring for new families in the hospital has a direct impact on benefitting the health and well-being of infants and mothers in the communities they serve. Despite notable improvements in Washington hospitals, there are still many opportunities to improve and enhance hospitalbased maternity care and infant nutrition practices. Dimensions of care where the average Washington score was low include Dimensions of Care Breastfeeding Infant Feeding Breastfeeding Assistance Contact b/w Mom & Baby Facility Discharge Care Structural & Organizational 1) Having all 10 model policy elements in the hospital breastfeeding policy (only 10% do), 2) Providing staff with appropriate breastfeeding education (12%), and 3) The use of nutrition supplements only when medically indicated. Only 36% of Washington facilities adhere to standard clinical practice guidelines against routine supplementation with formula, glucose water or water. Many Washington hospitals have taken important steps to enhance their maternity and infant nutrition standards of care. Four hospitals in Washington State are currently accredited by the Baby-Friendly Hospital Initiative, which is a global program that encourages and recognizes hospitals and birthing centers that offer an optimal level of care for infant feeding. These Wash's mpinc Scores Labor & Delivery Care Staff Training hospitals are: Evergreen Hospital Medical Center in Kirkland, Okanogan-Douglas District Hospital in Brewster, Tacoma General Hospital and the University of Washington Medical Center in Seattle. The Breastfeeding Coalition of Washington (BCW) has recently established the ad-hoc WA Baby-Friendly Advisory Committee to facilitate communication and collaboration between currently accredited Baby- Friendly hospitals and those that are working towards accreditation. There are several other hospitals in Washington that are working towards implementing the Ten Steps to Successful Breastfeeding and towards achieving Baby-Friendly accreditation as well. Maternity Care Practices Initiative The BCW and the Washington State Department of Health (DOH) are partnering with select hospital birthing % of WA facilities with ideal response WA 2009 WA 2007 facilities on the Maternity Care Practices Initiative, a statewide project that was recently endorsed by the Washington Healthcare Forum. This Initiative works to improve evidence-based perinatal care and infant nutrition in Washington hospitals. Six hospitals are currently partnered with the BCW and DOH and their commitment to enhancing their facilities perinatal breastfeeding support is resulting in impressive outcomes. These hospitals are Yakima Valley Memorial Hospital, Providence St Peter Hospital in Olympia, Providence Sacred Heart Medical Center and Providence Holy Family Hospital, both in Spokane, Skagit Valley Hospital in Mt. Vernon and Harrison Medical Center in Silverdale. To learn more about the mpinc and to view state reports, visit To read the Vital Signs: Hospital Support for Breastfeeding report, Breastfeeding/index.html. 6

7 Providence Regional Medical Center Everett s Human Milk Depot Human milk is the gold standard for infant nutrition. The American Academy of Pediatrics, World Health Organization, UNICEF, United States Surgeon General, and the Centers for Disease Control and Prevention are among the organizations that recommend breastfeeding as the natural and best source of infant feeding. Research shows that preterm infants fed human milk including banked, donor milk have better health outcomes than formula-fed babies. Providence Regional Medical Center Everett is working to open a human milk depot in This depot will accept and ship donated breast milk to a milk bank to be screened and processed. Institutions and individuals can purchase the donor milk from the bank for infants in need or potentially for adults who have conditions which cause them to be immunocompromised. Milk collected at Providence Regional s depot would not be used at Providence Regional, rather would go to the area of greatest need. Presently, Providence Regional plans to send donated milk to Presbyterian/St. Luke s Medical Center Mothers Milk Bank in Denver. This institution participates in, and adheres to the principles of, the Human Milk Banking Association of North America. Patricia Freeburg, Manager for Outpatient Women s Services at Providence Regional says, As a designated milk depot, Providence Regional will make a strong statement in the community about the health benefits of breast milk. With our focus on best practices, patient and family centered care, and encouraging informed choices in infant feeding, we are promoting excellence in health care. Health benefits from breast milk are seen immediately in the newborn period and continue throughout a lifetime. Providence Regional Medical Center Everett also hosts meetings of the Snohomish Breastfeeding Coalition, further showing their commitment to hospital and community support for breastfeeding families. Breastfeeding advocates and community volunteers in the Pacific Northwest are also working to open up the Northwest Mother s Milk Bank. Providence Health and Services has kindly donated office and lab space in Portland, OR for the milk bank and funds are still being raised to purchase the equipment needed to have a fullyfunctioning milk bank. To learn more about the NW Mother s Milk Bank and to donate to the Fill Our Space campaign, visit BCW Distributes Free Nursing Tank Tops in Time for World Breastfeeding Week The Breastfeeding Coalition of Washington and WithinReach would like to thank Bravado! Designs for their donation of more than 1,300 nursing tank tops. Thanks to Jenni Hogan, KIRO 7 morning traffic anchor and founder of and Tracy Corey, owner of Nurturing Expressions and a member of the King County Breastfeeding Coalition for helping to facilitate this wonderful gift. With the much-appreciated help of 11-year old volunteer and Girl Scout Mari Miller-Knox and WithinReach materials coordinator Debbie Nakano, the BCW sent out countless boxes of nursing tank tops to 33 WIC clinics across the state to be given directly to low-income breastfeeding moms. Thank you to everyone involved for helping make this great gift possible! Volunteer Mari Miller-Knox and BCW Program Manager packing and shipping over 1300 nursing tank tops! 7

8 Breastfeeding Welcome Here! The Center for Pediatric Dentistry (CPD) is a joint venture of the University of Washington School of Dentistry and Seattle Children s Hospital to combat the growing crisis of childhood dental disease. CPD had an estimated 30,000 patient visits in its first year of operation, with an emphasis on children with special needs from Western Washington and across the state. CPD serves children from birth through 18 years of age (special needs patients through 20 years of age), with programmatic emphasis on early childhood (birth to age 3). As so many families with young children come through their doors, CPD recognizes the importance of providing a welcoming environment for women to breastfeed their children and make this known by having the International Breastfeeding Symbol posted on their door. Have you seen the International Breastfeeding Symbol in use at a place of business? Please send the BCW a picture for consideration in a future issue of Breastfeeding Matters. If possible, please be sure the picture depicts the name of the business. Send to Rachel at rachels@withinreachwa.org. BCW Ramps Up Worksite Lactation Support Outreach A one page flyer on Worksite Lactation Support targeting businesses will soon be available for distribution to Washington employers. The flyer reviews the new federal worksite lactation support law, why employer support for breastfeeding moms is important and provides resources and tools for establishing worksite lactation support. The BCW is currently working to create a mailing list of Chamber of Commerce organizations across the state, and other business organizations and will send the flyer and an invitation letter out later this year. Included in the flyer is the offer to assist local businesses with the creation of their lactation support program, by connecting them with trained volunteers in their region. The BCW will also run a series of webinars for employers and Human Resources managers to review this information. For more information, visit Worksite Lactation Support Important Information for Employers About the new law: In 2010, the Fair Labor Standards Act was amended to include protection for breastfeeding employees. It states that employers shall provide breastfeeding employees with reasonable break time and a private, non-bathroom place free from intrusion to express breastmilk during the workday, up until the child s first birthday. Visit the Department of Labor website for more information: Why comply with the law? Providing worksite breastfeeding support is good for your business, your employees and their families. All major medical authorities recommend babies get only human milk for the first 6 months of life and continue to breastfeed for the first year or longer. In Washington State, more than 90% of new mothers initiate breastfeeding yet only 12% are still exclusively breastfeeding at 6 months. More than half of all mothers go back to work within a few months after the birth of a baby and returning to work is one of the most common reasons for giving up breastfeeding. Breastfeeding support is good for business! A worksite lactation support policy has many benefits to your business. Research shows providing breastfeeding support to employees results in: Higher productivity. Increased employee satisfaction and company loyalty. Lower rates of turn-over. A positive return on investment. Less absenteeism. Parents of formula-fed babies miss three times as much work compared to parents of breastfed babies. A good reputation in your community as a family-friendly business. Starting or enhancing your worksite lactation program is easy! Visit to access these resources: website provides a resource and information clearinghouse for employers and employees. The BCW also offers a webinar for businesses and HR professionals on the federal law and worksite lactation support. Visit or contact us: - breastfeedingcoalition@withinreachwa.org, phone This free toolkit was developed by the US Department of Health and Human Services and contains easy steps for businesses to support breastfeeding employees as well as guidance for mothers returning to work. National Business Group on Health- Investing in Workplace Breastfeeding Programs and Policies is a free toolkit for businesses to implement worksite lactation support and includes case studies and methods for measuring success. This flyer will be distributed to businesses throughout WA to encourage them to establish Worksite Lactation Support. Pierce County Spring Fair The Pierce County Breastfeeding Alliance had 15 members volunteer over 70 hours of their time so moms visiting the Spring Fair in Puyallup, WA from April would have a quiet place to nurse their babies and feel supported in a very public place. As in years past, in addition to providing rocking chairs and a changing area for families and an area for moms working at the Fair to pump in private, the Pierce County Breastfeeding Alliance also had an educational display for the thousands of people who walked through the Fair. The button machine was even put to work encouraging children and parents to celebrate breastfeeding long after the Fair is over! New in 2011 was a breastfeeding survey that was available for fairgoers to fill out. Most moms reported feeling supported as breastfeeding mothers with a few exceptions including lack of support from some family members, breastfeeding in public places or when at work. 8