World Breastfeeding Month, August 2014 1
Racial Disparities in Breast-Feeding May Start With Hospitals, Study Suggests Maternity care practices differ in neighborhoods with more black residents than average, CDC research finds THURSDAY, Aug. 21, 2014 (HealthDay News) -- Black mothers are less likely than white moms to breast-feed their babies, and here's one possible reason why: Hospitals in neighborhoods with many black residents do less to promote nursing than those in areas with more white residents, a U.S. government study finds. Key practices that support breast-feeding are much less common in medical centers where the black population is higher than average, researchers from the U.S. Centers for Disease Control and Prevention reported Thursday. These practices include efforts to initiate early breast-feeding, limited use of formula and "rooming-in" (keeping the mother and baby in the same room). "Breast-feeding has many health benefits for mothers and babies. Hospital practices during childbirth have a major impact on whether a mother is able to start and continue breastfeeding," the study authors noted. "These findings suggest there are racial disparities in access to maternity care practices known to support breast-feeding," Jennifer Lind and her CDC colleagues wrote in the Aug. 22 issue of the CDC's Morbidity and Mortality Weekly Report. Nationally, breast-feeding rates among black infants are about 16 percent lower than for white infants, the agency said. For this study, the researchers linked data from a 2011 U.S. survey on maternity practices in infant care and nutrition to U.S. Census data on the percentage of blacks living within the zip code area of a given health-care facility. Looking at more than 2,600 maternity centers overall, the investigators found a wide variation in implementation of 10 policies that support breast-feeding. Those practices included having a written policy supporting breast-feeding, prenatal breast-feeding education and limited use of pacifiers after childbirth. 2
Where the percentage of black residents was more than 12.2 percent (the national average from 2007 to 2011), the hospitals were less likely than centers elsewhere to meet five important indicators, the study found. Only 46 percent of hospitals in neighborhoods with more black residents than average promoted early initiation of breast-feeding versus nearly 60 percent of centers in areas with more white residents. Limited use of breast-feeding supplements was half as likely in hospitals in the more racially diverse neighborhoods (13 percent) compared with hospitals in neighborhoods with more white residents, the findings showed. And having the baby stay in the room with the mother was standard practice at about 28 percent of hospitals in neighborhoods with more black residents compared to 39 percent of centers in areas with more white residents. "The reasons for this disparity are unclear. However, this observation could provide insight into the reasons for the persistent gap in breast-feeding rates between black and white babies in the United States," according to a journal news release. "All hospitals can support mothers' breast-feeding decisions by applying policies and practices proven to be supportive of breast-feeding," the study authors concluded. More information The U.S. National Library of Medicine has more about the benefits of breast-feeding. SOURCE: U.S. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, Aug. 22, 2014 3
Louisiana WIC Breastfeeding Rates: 400.00 350.00 300.00 250.00 200.00 150.00 100.00 50.00 0.00 Participation Trends by Month - Fully BF Women Region 1 FBF Region 2 FBF Region 3 FBF Region 4 FBF Region 5 FBF Region 6 FBF Region 7 FBF Region 8 FBF Region 9 FBF 600.00 500.00 400.00 300.00 200.00 100.00 0.00 Participation Trends by Month - Partially BF Women Region 1 PBF Region 2 PBF Region 3 PBF Region 4 PBF Region 5 PBF Region 6 PBF Region 7 PBF Region 8 PBF Region 9 PBF 4
Congratulations for Achieving High Rates of Breastfeeding Mothers! Region 1: Daughters of Charity WIC Clinic 145 Region 2: WIC at Wooddale Clinic 152 Region 3: Aruna T. Sangisetty WIC 63 Region 4: Lafayette Parish Health Unit 130 Region 5: Calcasieu Parish Health Unit 82 Region 6: Rapides Parish Health Unit 119 Region 7: Bossier Parish Health Unit 61 Region 8: Ouachita Parish Health Unit 47 Region 9: Community Wellness Center WIC 109 5
World Breastfeeding Month Celebrations and Promotions Among Local Clinic: GREAT NEWS: Louisiana has 2 Baby Friendly Hospitals! Ochsner Health Center-Baton Rouge Terrebonne General Medical Center-Houma What is a Baby Friendly Hospital? Hospitals and maternity units set a powerful example for new mothers. The Baby-Friendly Hospital Initiative ( BFHI ), launched in 1991, is an effort by UNICEF and the World Health Organization to ensure that all maternities, whether free standing or in a hospital, become centers of breastfeeding support. A maternity facility can be designated 'baby-friendly' when it does not accept free or low-cost breastmilk substitutes, feeding bottles or teats, and has implemented 10 specific steps to support successful breastfeeding. 6
Ten steps to successful breastfeeding Have a written breastfeeding policy that is routinely communicated to all health care staff. Train all health care staff in skills necessary to implement this policy. Inform all pregnant women about the benefits and management of breastfeeding. Help mothers initiate breastfeeding within one half-hour of birth. Show mothers how to breastfeed and maintain lactation, even if they should be separated from their infants. Give newborn infants no food or drink other than breastmilk, unless medically indicated. Practice rooming in - that is, allow mothers and infants to remain together 24 hours a day. Encourage breastfeeding on demand. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic. USDA Final Food Rule Changes Effective 10-1-14: No Prescription Required! Medical Documentation from health care provider (Rx) no longer required for children to receive soy beverage. A full nutrition assessment by the CPA and appropriate documentation is required. Better Food Package! A partially (supplementing < ½ infant formula pkg.) breastfeeding woman who is also pregnant will receive the fully breastfeeding woman s food package. Additional Infant Formula! Infants on standard contract formula may receive additional formula during the 6-12 months age range in lieu of infant foods. Infant must have a qualifying condition as detailed in the requirements for special (exempt) formulas. Documentation is required. Change is good: 7
WIC Participation by Region: 30,000.00 Participation Trends by Month 25,000.00 20,000.00 15,000.00 10,000.00 5,000.00 - Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 8
Celebrate Breastfeeding: Breastfeeding and Nutrition Training 2014 Black Mothers Breastfeeding Association Speakers (Kiddada Green, Kendra Rowser, and Vincent Patrick) 9
Vendor and Program Integrity: Nutrition Education & Training: New Resources on WICworks! There is an updated MyPlate poster for moms available for order via WICworks. The How WIC Helps brochure has been updated and is also available to order. Please take advantage of these free resources. Order forms are on the home page at www.wicworks.nal.usda.gov. See attached memo for more information. 10
WIChealth.org: Please see the attached quarterly update. According to the report, clinics have not fully implemented online WIC nutrition education. The quarterly conference call is August 28 at 10:00 am. WIC employees may dial in 1-866-390-1828, access code 1412739. Training Documentation Reminder: Each clinic should maintain a training file with documentation of new employee trainings and annual required trainings for each employee. These are reviewed during management evaluations. 2014 Annual Civil Rights and Customer Service Training: The mandatory 2014 Annual Civil Rights and Customer Service Trainings modules are available now through the month of August. All WIC employees are required to complete both modules. The modules are located in the WIC LMS on the portal. Contact Barbara Cerniauskas with questions. Barbara.Cerniauskas@la.gov Obesity Prevention: Incorporate 5-2-1-0 Let s Geaux in WIC Services Contact Pam Romero at Pamela.romero@la.gov to order more of the following promotional materials for your WIC clinic: 1) 5-2-1-0 Let s Geaux posters and prescription/goal sheets 11
2) Food Scape Stickers 3) Farm to Fork Activity Books 4) Preventing Childhood Obesity DVDs (English and Spanish) Outreach Reports: Outreach Clinic outreach reports are due by the 10 th of each month to the Regional Nutritionist Regional Nutritionist yearly total reports due to state office by October 31, 2014 Farmers Market Nutrition Program: Farmers Market Nutrition Program (FMNP) September 30, 2014 is the deadline for distribution of FMNP coupon books 12
WIC FMNP Issuance Records due to Rebecca Riecke, Louisiana Department of Agriculture and Forestry by October 21, 2014 WIC participants have until November 30, 2014 to redeem Thank you for participating in the WIC FMNP this year! SEPTEMBER IS Fruits & Veggies- More Matters Month! September WIC Nutrition Education Topic, Let s Make a Meal includes the 5-2-1-0 goal sheet, poster and Preventing Childhood Obesity Video Encourage participants to visit their local farmers market CDC recently released a Vital Signs report, Progress on children eating more fruit, not vegetables Key points in the Vital Signs report include: The amount of whole fruit children eat increased by 67% from 2003-2004 to 2009-2010 but remained low. Vegetable intake remained unchanged during this same time period, and was also low. From 2003-2010, whole fruit replaced fruit juice as the main contributor of fruit to children s diets. Experts recommend that the majority of fruit come from whole fruit, rather than juice. About 60 million US children spend a significant amount of their day in child care (centers and homes, Head Start programs, preschool, and prekindergarten) or schools. Increased attention to food policies and 13
environments in these settings can contribute to progress in fruit and vegetable intake. The addition of WIC vouchers for fresh fruits and vegetables, nutrition education, the LA WIC FMNP and the 5-2-1-0 Let s Geaux! campaign are policy and environmental changes implemented to provide more opportunities for our LA WIC population to increase fruit and vegetable intake. Thanking you in advance for promoting Fruits & Veggies-More Matters Month! Hemopoint Machine Tech Support: Contact the technical support group at Stanbio for assistance with the hemoglobin analysis machine issues- Esther Salyers Technical Support/QC Specialist Tel: 800.531.5535 ext. 128 Email: lab@stanbio.com 14
Region 1-Lead Testing Pilot: Region 1 WIC Clinics and the Louisiana Healthy Homes and Childhood Lead Poisoning Prevention Program (LHHCLPPP) are partnering to provide lead testing for children ages 12-24 months in the Greater New Orleans and surrounding areas. As follow-up of the August 1, 2014 training, the LHHCLPPP will provide onsite lead testing in-services to Region 1 WIC clinic staff. Please contact Trina Evans at Trina.Evans@la.gov to provide dates of availability for onsite training. Job Opportunities: Part-time Nurse Consultant Southeast Louisiana Area Health Education Center together with the Louisiana Department of Health and Hospitals (DHH) Office of Public Health (OPH) Bureau of Family Health (BFH) seeks 2 part-time (.4 FTE) nurse consultants who will be responsible for the consultation of statewide and targeted regional efforts to help build and strengthen the state s breastfeeding program. Duties will include: assisting in the development of and providing hospital and community-based breastfeeding trainings, as well as train-the-trainer sessions in various areas of the state; providing technical assistance to hospital leaders and staff with emphasis on breastfeeding quality improvement strategies; facilitating in-person and online training for Medical providers, residents, as well as medical and nursing students 15
throughout the state. Some regional travel required. Position location: Baton Rouge, Alexandria, Shreveport, and/or Monroe. Qualifications: Licensed RN for the state of Louisiana; IBCLC preferred; at least 5 years experience working in breastfeeding promotion. Experience in training large groups. Excellent communication skills and comfortable with the use of technology. Interested candidates should email a cover letter and resume with 3 references to Marci Brewer at marci.brewer@la.gov. Deadline: September 12, 2014 Program Coordinator Southeast Louisiana Area Health Education Center together with the Louisiana Department of Health and Hospitals (DHH) Office of Public Health (OPH) Bureau of Family Health (BFH) seeks a full time program coordinator who will be responsible for the coordination of statewide, regional and community efforts to help build and strengthen the state s breastfeeding program. Duties will include: identifying and cultivating partnerships needed to develop and advance a collective impact strategy around breastfeeding; providing hands on technical assistance to hospital leaders and staff and facilitating sharing of best practices around prenatal and post-natal breastfeeding education and support; coordinate a physician office-based training; presenting information to community partners and to relevant agencies; assisting with collection of data to track program integrity and success. Statewide travel will be required. Position location: New Orleans. Qualifications: Masters in Public Health, Public Policy, or other relevant field. Experience working in breastfeeding promotion. Experience working with diverse populations and community engagement. Excellent communication skills. 16
Interested candidates should email a cover letter and resume with 3 references to Marci Brewer at marci.brewer@la.gov. Deadline: September 12, 2014. Participant Optional Survey-Feel Free to Share with Caregivers: 17
School is in session for most parishes! Children ages 1-5 may be attending daycare or head start programs. Please make reasonable WIC appointment scheduling accommodations for the caregivers. Students are allowed to miss a limited number of school days. Providing non-traditional WIC clinic hours is always an option and is highly encouraged. 18