Eligiblity

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• Elements of a Successful Breastfeeding
• Program
• San Marcos, California
• 760-752-4324

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NCHS WIC Agency Profile

• 5 permanent sites and 3 satellite clinics
  throughout Northern San Diego County.
• 35 Full and Part Time Staff.
• Participation 10,654 (2/08)
• English 41.5, Spanish 57.8 and Languages.
• Number of Infants 2358 (2/08)
• 1 Part-time IBCLC
• 10 CLEs and 6 more in training

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Staff Training, Pump Loan and Other Elements

• Extensive Staff Training
• Yearly in-house trainings for all other staff.
• Thorough training for new staff.
• Brought CLE training to our agency.
• Breast Pump Loan Program
• Over 200 electric breast Pumps to lend.
• Breastfeeding Friendly Environment
• Referral Systems
• WIC staff can refer complex BF problems to the
  CLE or IBCLC.
• NCHS providers refer BF problems back to WIC.
• Breastfeeding promotion is everyones job!

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Comprehensive Participant Education and Support

• Two prenatal breastfeeding classes.
• A Why To BF and a How To BF.
• All prenatal ppts. are made aware of our No
  formula in the first month policy.
• Early post-partum BF support phone calls to ALL
  new mothers.
• Breastfeeding Warm-Line for ppts to call with
  questions.
• Breastfeeding support groups.

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No Formula in the First Month

• Set a date 9 months in advance to start policy.
• Begin with extensive staff training, so all are
  comfortable discussing and supporting
  breastfeeding.
• Start telling all pregnant women at enrollments,
  trimester checks and classes that WIC doesnt
  routinely give formula to breastfed babies less
  than one month old.
• Enroll baby then recertify post partum mother the
  following month, so they receive two contacts of
  BF support.
• If they want to combo feed, tell them they can
  after exclusively breastfeeding for the first
  month.
• We find after they get through the first month,
  they often dont need the formula in the second
  month.
• Formula is only given in extenuating
  circumstances with supervisor approval.

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Early Postpartum Phone Call Study

• Hypothesis WIC mothers who received an early
  postpartum phone call to offer BF support will be
  more likely to exclusively breastfeed and
  breastfeed for a longer period of time than a
  control group.
• Babies born to NCHS WIC from 10/03 and 11/03 were
  in study and FIs were followed for a year.
• Half received phone calls (intervention) and half
  did not (control).

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Our Study Population
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We Made a Difference!
Statistically Significant at .05
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Why it Worked

• Connected with Mothers at their time of need
• The calls were beyond the normal WIC clinic
  services
• They were reached at a vulnerable time in
  breastfeeding.
• Mothers had 100 of our attention,
• Staff were given time to make call, build
  rapport with women.
• The intervention was individual and personal.
• Well-trained staff
• Open ended closed questions were asked that
  allowed us to educate, guide and reassure.
• WIC is a trusted resource.

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Conclusion

• Early phone intervention helped the group of
  mothers have a better breastfeeding experience,
  and prevented them from quitting prematurely.
• Using early postpartum phone intervention calls,
  we increased breastfeeding exclusivity and
  duration.
• Early postpartum phone intervention fits within
  the scope of WIC services.
• The calls could be easily replicated in other
  settings.

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• NCHS WIC Program
• Policies
• and
• Procedures