Healthy People 2020 Community Innovations Project Form A Cover Page

Healthy People 2020 Community Innovations Project Form A Cover Page Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) Organization/Group Tax ID #: 06-1774339 Organization/Group Total Annual Budget: $12,935 Mailing Address: 26230 Indian Cliff, San Antonio, TX 78260 Proposal Contact Name: Amy K. Duval, BSN, RN, IBCLC Proposal Contact Title: President - Executive Director Email: jamyduval@sbcglobal.net Phone: 210-724-8211 Fax: 1-866-455-1174 Total Amount Requested ($5,000 to $10,000): $10,000 Please select which of the following RFP priority areas your proposed project will address: Environmental Justice Health Equity Healthy Behaviors Across the Lifespan Briefly describe your project (150 word limit): The San Antonio Breastfeeding Coalition (SABC) is planning a professional conference titled The 2012 Texas Breastfeeding Summit: Improving Exclusive Breastfeeding Rates in the Hospital Setting. Breastfeeding initiation, duration, and exclusivity rates are directly influenced by hospital policy and the optimal care provided by staff during the first days after birth. Supporting breastfeeding mothers is a Center for Disease Control (CDC) key strategy to improve the health of mothers and their children. When mothers receive little or unhelpful breastfeeding support in the hospital, their efforts at exclusively providing breastmilk to their baby is short lived. The success rate among mothers who want to breastfeed can be greatly improved through active support from health care providers and leaders at the facility where they choose to deliver their baby. This funding opportunity will allow SABC to offer professional scholarship packages to assure the attendance of this target audience. Healthy People 2020 Community Innovations Project Request for Proposal I Page 1

Healthy People 2020 Community Innovations Project Form B Applicant Description Page Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) Please use the following as subheadings to outline your response to the applicant description section: 1. Describe your organization/group and its purpose. 2. Describe the background and experience of your staff with similar projects. 3. Describe your organization/group s experience working in the community. 4. Describe how the community was involved in planning the proposed project. 5. If you are partnering with other groups, please list and describe them below. Responses: 1. Describe your organization/group and its purpose. The San Antonio Breastfeeding Coalition (SABC) is a nonprofit community based coalition of organizations and breastfeeding advocates committed to working together on the design and implementation of practical, evidence-based strategies to promote, support, and protect breastfeeding through education, outreach, and advocacy. SABC is recognized as the coordinating resource for breastfeeding support and education in the San Antonio area. In addition, the SABC assists the Texas Department of State Health Services (DSHS), the Center for Disease Control and Prevention (CDC), the Texas Breastfeeding Coalition (TXBC), the United States Breastfeeding Committee (USBC) and other partners by disseminating information and promoting programs and initiatives related to improving outcomes in maternity and infant health. A complete list of current programs and Healthy People 2020 Community Innovations Project Request for Proposal I Page 2

accomplishments can be viewed at www.sabctx.org. 2. Describe the background and experience of your staff with similar projects. The San Antonio Breastfeeding Coalition is committed to providing the professional community opportunities and scholarships to attend evidenced-based workshops and conferences in an effort to increase breastfeeding knowledge and support practices. The SABC staff developed and coordinated the following conferences: May 2006, Barbara Wilson Clay, BEd, IBCLC, FILCA presented, Ethical Dilemmas for the Lactation Consultant, at St. Luke s Baptist Hospital in San Antonio, TX. Target audience: Lactation Consultants. Attendance: 50. Continuing Education: CERPs. February 2008, Pamela Berens, MD presented, Supporting Breastfeeding When Challenges Occur, at North Central Baptist Hospital in San Antonio, TX. Target audience: Physicians and Nurse Practitioners. Attendance: 36. Continuing Education: CMEs and CERPs. February 2009, Diana West, IBCLC and Lisa Marasco, MS, IBCLC presented, The Low Breastmilk Supply Conference, at CHRISTUS Santa Rosa Hospital in San Antonio, TX. Target audience: Lactation Consultants and Nurses. Attendance: 112. Continuing Education: CERPs. Healthy People 2020 Community Innovations Project Request for Proposal I Page 3

3. Describe your organization/group s experience working in the community. In addition to professional development, SABC strives at a grassroots level to bring breastfeeding education and awareness activities to the San Antonio community that represents our overall mission to promote, protect, and support breastfeeding. SABC strategically plans professional and community activities throughout the year. Examples include the following: The Annual San Antonio Quintessence Breastfeeding Challenge with other community partners such as La Leche League, WIC, and the Metro-Health Department. This funeducational event is an international challenge to identify which geographic area (province, state or territory) has the most breastfeeding babies, as a percentage of the birthrate, latched on at 11:00 am local time. San Antonio had the most latched in the United States in 2010! This event promotes the normalcy of breastfeeding in public. Evidenced-based breastfeeding related presentations and conferences. World Breastfeeding Week educational activities and luncheons in the month of August at various locations in the community. The San Antonio Area Breastfeeding Resource Directory distribution to breastfeeding families and professionals through local hospitals and WIC agencies. SABC website serves as a breastfeeding resource and clearinghouse for information for professionals and the community www.sabctx.org. Scholarships for health care professionals to attend advanced practice workshops and conferences. Exhibitor in health fairs and conferences. Healthy People 2020 Community Innovations Project Request for Proposal I Page 4

Resource to the media for breastfeeding related stories and press releases. 4. Describe how the community was involved in planning the proposed project. Social and environmental support for breastfeeding has been brought to the forefront of our nation s public health priorities with the launch of the Healthy People 2020 objectives, the Surgeon General s 2011 Call to Action to Support Breastfeeding, and Michelle Obama s Let s Move national campaign. In response, SABC initiated a community-based task force to plan this educational summit that will target breastfeeding rates at the hospital level. This committee includes SABC members, partnering organizations and representatives from local hospitals including their physicians, lactation consultants, and nurses. This task force identified the following key elements for the conference planning: The need for breastfeeding education at the hospital level with attendance of key decision makers and health clinicians Importance of internationally known speakers to present evidenced based topics that would compel changes in hospital practices that impact breastfeeding rates Conference objectives to target the Healthy People 2020 breastfeeding goals 5. If you are partnering with other groups, please list and describe them below. LLL- La Leche League is an international, nonprofit, nonsectarian organization dedicated to providing education, information, support, and encouragement to women who want to breastfeed. La Leche League of Texas also provides health care professionals with continuing education opportunities and access to the latest research on Healthy People 2020 Community Innovations Project Request for Proposal I Page 5

lactation management. TXBC-Texas Breastfeeding Coalition is a consortium of breastfeeding promotion groups, organizations that work with mothers and babies, and interested individuals from across the state. UTHSCSA-University of Texas Health Science Center at San Antonio School of Nursing Continuing Nursing Education (CNE) department offers well planned, innovative program opportunities for life-long learning in the area of continuing professional education to meet the needs of the nursing community throughout the nation. March of Dimes - San Antonio is a nonprofit organization whose mission is to improve the health of babies by preventing birth defects, premature birth and infant mortality. USLCA-United States Lactation Consultant Association is an organization whose mission is to build and sustain a national association that advocates for lactation professionals as valued recognized members of the health care team.. Healthy People 2020 Community Innovations Project Request for Proposal I Page 6

Healthy People 2020 Community Innovations Project Form C Project Description Page Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) Please use the following as subheadings to outline your response to the project description section: 1. Describe the community s need for this project and which members of the community will be served by the project. 2. Please list which Healthy People 2020 topic area(s) and objective(s) your project will address. 3. Describe what you want to accomplish with this project. Please list your goal(s) for this project. 4. How will this project guide efforts to achieve Healthy People 2020 targets? Responses: 1. Describe the community s need for this project and which members of the community will be served by the project. Breastfeeding, especially exclusive breastfeeding, is one of the most effective preventive health measures available to reduce child morbidity and mortality. Evidence demonstrates a direct correlation between the care given in the hospital with breastfeeding rates. The Baby-Friendly Hospital Initiative (BFHI) was developed by the World Health Organization (WHO) and UNICEF to promote and protect maternal and child health by making breastfeeding the norm and ensuring support in maternity care facilities. Unfortunately, findings from the 2007 CDC survey, Maternity Practices in Infant Feeding and Care (mpinc), documented poor adherence with evidenced based breastfeeding practices in the hospital setting. The mpinc survey reports a Texas composite quality practice score of 58 out of 100 with the low national ranking of 39. The Surgeon General s 2011 Call to Action to Support Breastfeeding also reports lack of up-todate instruction and information from health care professionals to mothers. Healthy People 2020 Community Innovations Project Request for Proposal I Page 7

Research shows children who are breastfed for six months are less likely to develop obesity and diabetes. In the U.S., 75% of mothers initiate breastfeeding however only 13% of babies are exclusively breastfed at the end of six months. First Lady, Michelle Obama, has included breastfeeding in the Let s Move national campaign as a primary source of prevention of childhood obesity. The journal of Pediatrics reports the U.S. would save $13 billion per year in health care costs if U.S. families complied with medical recommendations to breastfeed. The Texas Department of State Health Services and the Center for Disease Control s 2010 Behavioral Risk Factor Surveillance System identifies the following health related disparities in San Antonio: 32.3 % of the population is obese (BMI of 30 or greater) compared to the national rate of 28.9 % 10.7 % of the population is diabetic compared to the national rate of 9.3 % 16.7 % of the population has no health insurance compared to the national rate of 15.1% Quality breastfeeding care at the hospital level will improve breastfeeding exclusivity rates and will ultimately impact both the fiscal and physical health of the San Antonio community. 2. Please list which Healthy People 2020 topic area(s) and objective(s) your project will address. Topic Area: Infant Care Objectives: MICH-21 Increase the proportion of infants who are breastfed Healthy People 2020 Community Innovations Project Request for Proposal I Page 8

MICH-23 Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life MICH-24 Increase the proportion of live births that occur in facilities that provide recommended care of lactating mothers and their babies 3. Describe what you want to accomplish with this project. Please list your goal(s) for this project. SABC is expecting 200 onsite conference attendees. The goal for this project and funding is to assure 25% or more of conference attendees are hospital decision makers and health clinicians such as nurses, physicians, and administrators who directly impact early maternity care practice. A task force with representatives from each local hospital will make 75 nominations to award 57 scholarship packages to this target audience (Attachment 1-Scholarship Package Sample). Scholarship recipients will be provided with a paid registration and an honorary SABC membership. This personalized recognition and invitation will compel attendance and promote long-term participation in SABC. The conference will provide hospital staff with evidence based information that inspires a cultural change in how breastfeeding is managed and stimulate discussion about policy changes that eliminate institutional barriers to breastfeeding. A baseline of current practice will be established by conducting a pre-conference survey which will allow SABC to collect information about each participant s work environment. A three month post-conference online survey will serve as a measure of effectiveness of the conference in its ability to be a catalyst for positive change in breastfeeding clinical practices. Results will influence future planning of conferences and strategic initiatives that promote breastfeeding and the Healthy People 2020 goals in the community (Attachment 2- Conference Surveying Tools). Post conference survey tool will be reformatted for online distribution through Survey Monkey. Healthy People 2020 Community Innovations Project Request for Proposal I Page 9

4. How will this project guide efforts to achieve Healthy People 2020 targets? Scholarship opportunities and keynote speakers will encourage the attendance of the target audience. Conference speakers will present topics that reflect how to influence the early care and interventions of the breastfeeding family (Attachment 3-Conference Agenda). The following conference topics target the HP2020 objectives MICH-21, 23 and 24: Conference Goal #1 (Targets HP2020 Objective MICH 21): Participants will demonstrate understanding of the Joint Commission Core Measure Program for Perinatal Care, how data for each measure is collected and reported, and how hospital specific scores can be used to increase the proportion of infants who are breastfed. Topic: Update on the Perinatal Care (PC) Core Measure Set. Session Description: This presentation will provide resources on ways to implement the PC core measures with emphasis on breastfeeding promotion. Conference Goal #2 (Targets HP2020 Objective MICH 21): Participants will understand the advantages of a Baby-Friendly Hospital (BFHI) designation for their facility including strategies for pursuing the process. Topic: Baby Friendly Hospital Initiative Best Practice Presentation Session Description: This presentation will tackle the tough issues and summarize the positive impact BFHI has on exclusive breastfeeding rates. Conference Goal #3 (Targets HP2020 Objective MICH 23): Participants will identify when to supplement a breastfed infant and discuss interventions that reduce the proportion of breastfed newborns who receive unnecessary formula supplementation Healthy People 2020 Community Innovations Project Request for Proposal I Page 10

within the first two days of life. Topic: Stemming the Tide of Supplementation Session Description: This presentation explores the reason for necessary and unnecessary supplementation as well as when, why, and how to supplement if necessary. Conference Goal #4 (Targets HP2020 Objectives MICH 21,23,24): Participants will be able to discuss interventions that increase the proportion of infants who are exclusively breastfed in the hospital. Topic 1: Improving Maternity Care Practices: Raising Your mpinc Score Session Description: This presentation will cover how to use facility scores as a tool to create a more supportive environment for breastfeeding families. Topic 2: Providing Optimal Care in the Hospital: It s OUR Responsibility Session Description: This session explores how to overcome problems associated with hospital practices, lack of lactation support staff, and the role of the bedside nurse in providing optimal breastfeeding care. Conference Goal #5 (Targets HP2020 Objectives MICH 21,23,24): Participants will have an opportunity to discuss facility specific breastfeeding concerns with a panel of breastfeeding experts in an open forum. Topic: Question and Answer Panel Session Description: This portion of the conference will provide dialogue for clarification and further exploration into material presented. Healthy People 2020 Community Innovations Project Request for Proposal I Page 11

Healthy People 2020 Community Innovations Project Form D Project Work Plan Page Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) Please describe your planned activities in the table below. Project Activities Start Date End Date Person Responsible Implement Conference Task Force 01/01/2011 9/18/2012 Amy Duval-Executive Director Develop Scholarship Package Contents 7/01/2011 10/10/2011 Mary Beth Blue-Project Director Seek Scholarship Funding HP2020 06/30/2011 08/05/11 Amy Duval-Executive Director Identify Nominating Committee 07/01/2011 8/05/2011 Dena Miller-Education Coordinator Identify Hospital Representatives 10/10/2011 10/10/2011 Dena Miller-Education Coordinator HP2020 Intent to Fund or 11/11/2011 John Snow, Inc. Decline Announcement Project Timeline (HP2020) 12/01/2011 5/31/2012 Amy Duval-Executive Director Print Scholarship Package 12/01/2011 12/07/2011 Patricia Stark-Secretary Distribute Scholarship 12/07/2011 12/21/2011 Patricia Stark-Secretary Packages (75) Board of Director-Nominee Review and Approval 12/21/2011 2/03/2012 Amy Duval-Executive Director Process Registrations and Confirmation 12/21/2012 2/03/2012 Dena Miller-Education Coordinator Pre-Conference Survey 12/21/2012 2/03/2012 Mary Beth Blue-Project Director Conference Reminder calls and emails 2/03/2012 2/15/2012 Amy Duval-Executive Director Conference Date 2/18/2012 2/18/2012 Conference Task Force and UTHSCSA Post Conference Evaluation 2/18/2012 2/28/2012 Mary Beth Blue-Project Director HP2020 Evaluation Component Due 6/10/2012 Amy Duval-Executive Director Post Conference Survey (3 months) and final report 5/18/2012 5/31/2012 Mary Beth Blue / Amy Duval Healthy People 2020 Community Innovations Project Request for Proposal I Page 12

Healthy People 2020 Community Innovations Project Form E Budget Form Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) List each of your expected costs associated with your proposed work plan in the table below. Item Description Cost ($) Justification Funding Source 1. SABC Membership Fees (57 x $10 each) 2. Conference Registrations Fees (57 x $150 each) Does not include cost for catering. 3. Printing Costs for scholarship package 4. Materials for scholarship package $570.00 Sustain SABC participation $8550.00 Incentive to attend. Conference continuing education credits and materials $380.00 Conference brochure, letter, and nomination forms $500.00 SABC marketing HP2020 Community Innovations Project HP2020 Community Innovations Project Recipients that do not show or cancel timely will be charged a deposit. These funds will be managed at the discretion of the grantor- HP2020. HP2020 Community Innovations Project HP2020 Community Innovations Project items, folders Scholarship Total $10,000 HP2020 Community Innovations Project This funding request is for scholarships and will not cover food expenses 5. Conference Expenses $51,843.50 continuing education credits, materials, honorariums Conference Total $51,843.50 TOTAL $61,843.50 SABC fundraising, March of Dimes grant, conference registration fees, sponsorships and exhibitors Healthy People 2020 Community Innovations Project Request for Proposal I Page 13

Healthy People 2020 Community Innovations Project Form F Budget Information Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) Name of Person Responsible for Managing Project Funds: Mary Beth Blue, BSN, MA, RN, IBCLC Position at Organization/Group: Vice President Project Director Mailing Address (Street address, Ste/Unit #, City, State/US Territory, Zip Code): 1174 Lost Trail New Braunfels, TX 78132 Email: Mblue5000@yahoo.com Phone: 210-860-6694 Fax: 1-866-455-1174 Healthy People 2020 Community Innovations Project Request for Proposal I Page 14

Healthy People 2020 Community Innovations Project Form G Evaluation Agreement Form Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) I agree to participate in an evaluation of this project and submit all required evaluation materials by June 10, 2012. Amy K. Duval, BSN, RN, IBCLC (SABC President) 08/04/2011 Name of Responsible Party Date 210-724-8211 jamyduval@sbcglobal.net Responsible Party s Phone Number Responsible Party s Email Address Healthy People 2020 Community Innovations Project Request for Proposal I Page 15

Healthy People 2020 Community Innovations Project Form H References & Attachments (Optional) Organization/Group Name: San Antonio Breastfeeding Coalition, Inc. (SABC) References: American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the use of Human Milk. Pediatrics. 2005;115:496-506 http://aappolicy.aappublications.org/cgi/reprint/pediatrics;115/2/496.pdf Bartick M, Stuebe A, Shealy K, et al. Closing the Quality Gap: Promoting Evidenced Based Breastfeeding Care in the Hospital. Pediatrics 2009;124;124e793- e802: originally published online Sep 14, 2009; DOI:10.1542/ped.2009-0430 http://www.pediatrics.org/cgi/content/full/124/4/e793 Abrahams W, Labbock M. Exploring the Impact of the Baby-Friendly Hospital Initiative on Trends in Exclusive Breastfeeding. International Breastfeeding Journal 2009, 4:11. http://www.internationalbreastfeedingjournal.com/content/4/1/11 The CDC Maternity Practices in Infant Nutrition and Care (mpinc) survey 2007. www.cdc.gov/mpinc U.S. Department of Health and Human Services. The Surgeon General s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011. http://www.surgeongeneral.gov/topics/breastfeeding/index.html White House Taskforce on Childhood Obesity (2010). Solving the problem of childhood obesity within a generation. Report to the President. Washington, DC: Executive Office of the President of the United States. http://www.letsmove.gov/obesitytaskforce.php Texas Department of State Health Services: 2010 Behavioral Risk Factor Surveillance System: http://www.dshs.state.tx.us/chs/brfss/query/brfss_form.shtm Bartick M, Reinhold A. The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics 2010; 125:5 e1048-e1056 http://pediatrics.aappublications.org/content/125/5/e1048.full.html Healthy People 2020 Community Innovations Project Request for Proposal I Page 16

Healthy People 2020 Community Innovations Project Form H References & Attachments (Optional) Attachment 1- Scholarship Package Sample San Antonio Breastfeeding Coalition Nomination Tool - SAMPLE Hospital Affiliation: SABC Hospital Representative: Nominee Name: Phone Number: Address: Email: Background Information: Staff Nurse-RN, LVN Unit: Hospital Administrator- Title: Nurse Manager- Unit: Physician- Specialty: Not a lactation consultant (lactation consultants are not eligible) Additional Information: SABC Use: White copy-sabc Yellow copy-scholarship Recipient BOD review and approval Signature: Commitment form signed Online Registration completed by SABC Pre-Conference survey completed Reminder call and email (one week prior to conference) Honorary Membership Certificate (to be distributed at conference) Post Conference Evaluation and survey (online) Healthy People 2020 Community Innovations Project Request for Proposal I Page 17

San Antonio Breastfeeding Coalition Invitation/Letter - SAMPLE Date: Scholarship Nominee Name Hospital Affiliation Dear, Congratulations for being nominated to receive a scholarship to attend the 2012 Texas Breastfeeding Summit: Improving Exclusive Breastfeeding Rates in the Hospital Setting on Saturday, February 18, 2012 at the La Quinta Medical Center Conference Center. This scholarship is valued at $150 and funded through a grant awarded by the Healthy People 2020 Community Innovations Project. Lunch and snacks will be provided by the San Antonio Breastfeeding Coalition. With your conference attendance you will be eligible for continuing education credits and an honorary SABC membership. Your conference host, The San Antonio Breastfeeding Coalition (SABC), is a nonprofit community based coalition of organizations and breastfeeding advocates committed to working together on the design and implementation of practical, evidence-based strategies to promote, support, and protect breastfeeding through education, outreach, and advocacy. Research has shown that breastfeeding, especially exclusive breastfeeding, is one of the most effective preventive health measures available to reduce child morbidity and mortality. This goal of this conference is to provide hospital staff and decision makers with evidenced based information that inspires a cultural change in how breastfeeding is managed and stimulate discussion about policy changes that eliminate institutional barriers to breastfeeding. To accept this nomination, complete the enclosed Commitment Form and Pre-Conference Survey and submit to SABC by January 25, 2012. Please find additional conference information and events enclosed. Congratulations again, for your nomination! We look forward to meeting you. Sincerely, Amy K. Duval, BSN, RN, IBCLC President San Antonio Breastfeeding Coalition www.sabctx.org Healthy People 2020 Community Innovations Project Request for Proposal I Page 18

San Antonio Breastfeeding Coalition Commitment Form - SAMPLE Registration Information: Submission Date: Submission Deadline: January 25 th 2012 Hospital Affiliation: Name / Credentials: Phone Number: Email: Mailing address: City: State: Zip code: Continuing Education: CE Nurse CERP Lactation Both I commit to attend the Texas Breastfeeding Summit: Improving Exclusive Breastfeeding Rates in the Hospital Setting on February 18, 2012. I understand my account will be charged a cancellation fee in the amount of if I do not attend the conference or forfeit this scholarship by February 3, 2012. Signature Date Your SABC contact is: _ White copy-sabc Yellow copy-scholarship Recipient Check Check # Credit Card Type Exp. Date Credit Card # Code Zip Healthy People 2020 Community Innovations Project Request for Proposal I Page 19

Healthy People 2020 Community Innovations Project Form H References & Attachments (Optional) Attachment 2- Conference Survey Tools Improving Exclusive Breastfeeding Rates in the Hospital Setting February 18, 2012 Pre-Conference Survey Conference Objective: To provide hospital staff with evidenced based information that inspires a cultural change in how breastfeeding is managed and stimulate discussion about policy changes that eliminate institutional barriers to breastfeeding. According to a new report from the CDC, less than 4% of hospitals in the US offer the full support needed for breastfeeding mothers and only 14% have a written breastfeeding policy. In addition, nearly 80% of hospitals give formula to infants who are healthy and breastfeeding when it is not medically necessary! Last Name: First name: Credentials: Street address: City: State: Zip code: E-mail: Facility name: Facility address: City: State: Zip code: Job title Identify your primary job function at your facility: Hospital staff nurse Hospital women s services manager Hospital administrator Medical staff Midwife Nurse practitioner Physician Lactation Consultant Public health representative Other Healthy People 2020 Community Innovations Project Request for Proposal I Page 20

Please complete this pre-conference survey by indicating one number for each question. Your responses will help identify practices in place at your facility prior to attending the conference. For questions 1-17 please use the following rating scale: 1 = Do not know what this is 2 = Do not have 3 = Will consider 4 = Will implement 5 = Have A. Please indicate the status of the following evidence based maternity care practices in your facility: 1. Discharge packs containing formula are not given to breastfeeding patients 2. Mothers and babies are not separated during the hospital stay 3. Initial skin-to-skin contact is > 30 minutes within 1 hour of vaginal birth 4. Supplemental feedings to breastfed infants are rare 5. Staff rarely provide pacifiers to breastfed infants 6. Non-rooming-in infants are brought to mothers at night for feedings 7. Appropriate breastfeeding education is given to new staff 8. Appropriate breastfeeding education is given to current staff annually 9. Breastfeeding is included in prenatal patient education 10. There is a designated staff member responsible for coordination of lactation care 11. Developed a hospital breastfeeding policy 12. Changed our hospital breastfeeding policy 13. Added lactation consultant position(s) 14. Initiated staff breastfeeding education requirements 15. Increased staff breastfeeding education requirements 16. Chose the Perinatal Care Core Measure set 17. There is a plan to ensure adherence to the Joint commission s Perinatal Care Core Measure Set. Healthy People 2020 Community Innovations Project Request for Proposal I Page 21

C. How did you learn about this conference: D. Additional comments: Thank you for registering and participating in the pre-conference survey Healthy People 2020 Community Innovations Project Request for Proposal I Page 22

Improving Exclusive Breastfeeding Rates in the Hospital Setting February 18, 2012 3 Month Post-Conference Survey (Online) Conference Objective: To provide hospital staff with evidenced based information that inspires a cultural change in how breastfeeding is managed and stimulate discussion about policy changes that eliminate institutional barriers to breastfeeding. According to a new report from the CDC, less than 4% of hospitals in the US offer the full support needed for breastfeeding mothers and only 14% have a written breastfeeding policy. In addition, nearly 80% of hospitals give formula to infants who are healthy and breastfeeding when it is not medically necessary! Last Name: First name: Credentials: Street address: City: State: Zip code: E-mail: Facility name: Facility address: City: State: Zip code: Job title Identify your primary job function at your facility: Hospital staff nurse Hospital women s services manager Hospital administrator Medical staff Midwife Nurse practitioner Physician Lactation Consultant Public health representative Other Please complete this post conference survey by indicating one number for each question. Your responses will help identify changes that have occurred as a result of attending the conference and help SABC plan future educational opportunities. For questions 1-17 please use the following rating scale: Healthy People 2020 Community Innovations Project Request for Proposal I Page 23

A. Please indicate the status of the following evidence based maternity care practices in your facility: 1 = Do not know what this is 2 = Do not have 3 = Will consider 4 = Will implement 5 = Have 1. Discharge packs containing formula are not given to breastfeeding patients 2. Mothers and babies are not separated during the hospital stay 3. Initial skin-to-skin contact is > 30 minutes within 1 hour of vaginal birth 4. Supplemental feedings to breastfed infants are rare 5. Staff rarely provide pacifiers to breastfed infants 6. Non-rooming-in infants are brought to mothers at night for feedings 7. Appropriate breastfeeding education is given to new staff 8. Appropriate breastfeeding education is given to current staff annually 9. Breastfeeding is included in prenatal patient education 10. There is a designated staff member responsible for coordination of lactation care 11. Developed a hospital breastfeeding policy 12. Changed our hospital breastfeeding policy 13. Added lactation consultant position(s) 14. Initiated staff breastfeeding education requirements 15. Increased staff breastfeeding education requirements 16. Chose the Perinatal Care Core Measure set 17. There is a plan to ensure adherence to the Joint commission s Perinatal Care Core Measure Set B. Additional comments: Thank you for attending the conference and participating in the post-conference survey Healthy People 2020 Community Innovations Project Request for Proposal I Page 24

Healthy People 2020 Community Innovations Project Form H References & Attachments (Optional) Attachment 3-Conference Agenda DATE: February 18, 2012 TITLE: 2012 Texas Breastfeeding Summit: Improving Exclusive Breastfeeding Rates in the Hospital Setting 7:00 8:00 Registration Continental Breakfast Exhibit Hall Open 8:00 8:15 Announcements 8:15 8:30 Welcome and Opening Remarks Keynote Speaker TBA 8:30 9:30 Session I Improving Maternity Care Practices and Raising Your mpinc Score Marsha Walker, RN, IBCLC 9:30 10:00 BREAK Exhibit Hall Open 10:00 11:00 Session II Providing Optimal Breastfeeding Care in the Hospital: It s OUR Responsibility Rebecca Mannel, BS, IBCLC, FILCA 11:00 12:00 Session III Stemming the Tide of Supplementation Healthy People 2020 Community Innovations Project Request for Proposal I Page 25

Marsha Walker, RN, IBCLC 12:00 1:00 LUNCH and Announcements Exhibit Hall Open 1:00 2:00 Session IV Update on Perinatal Care Core Measure Set Celeste G. Milton, MPH, BSN, RN 2:00 3:00 Session V Baby Friendly Hospital Initiative Best Practice Presentation Trish MacEnroe, BS, CDN, CLC, Executive Director, Baby Friendly USA 3:00 3:15 BREAK and Exhibit Viewing (Afternoon Snack) 3:15 4:15 Session VI The Journey to Becoming a Baby Friendly Hospital Becky Law, BSN, RN, IBCLC 4:15 4:45 Q&A Panel 4:45 5:00 Closing Remarks/Evaluation and CE Instructions Healthy People 2020 Community Innovations Project Request for Proposal I Page 26