Texas Mother-Friendly Worksite Program - Breastfeeding …



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Mother-Friendly minimum criteria for education: There is no requirement to provide an education component in order to become designated as a Texas Mother-Friendly Worksite.

Mother-Friendly minimum criteria for support: To achieve and maintain designation as a Texas Mother-Friendly Worksite, a worksite must provide and maintain a written worksite lactation support policy that is regularly communicated to employees and:

(1) Provides work schedule and work pattern flexibility to, at a minimum, accommodate

a reasonable break time for an employee to express breastmilk for her nursing child or breastfeed each time such employee has need to express milk or breastfeed for one year

or longer after the child's birth.

(2) Provides employees a private, accessible area, other than a bathroom, that is shielded

from view and free from intrusion from co-workers and the public, for either expressing breastmilk or breastfeeding each time such employee has need to express breastmilk

or breastfeed.

(3) Provides access to a clean, safe water source and a sink.

(4) Provides access to a hygienic place to store expressed breastmilk.

To provide a comprehensive lactation support program, consider offering some or all of the following education resources to expectant and parenting employees:

• A lending library of educational breastfeeding pamphlets, books, and/or videos.

• Web links to educational resources from the company’s wellness or other intranet page.

• Referrals to classes on pregnancy and breastfeeding.

• Classes on pregnancy and breastfeeding at the worksite or subsidized classes offered in the community.

• A return-to-work consultation by a Trained Breastfeeding Educator or an International Board-Certified Lactation Consultant.

• Educational options extended to employees’ partners/immediate family members.

Actively promote the worksite’s support for employees and their families who wish to combine working and breastfeeding:

• Place posters, signs, and/or displays in common areas and in the lactation space indicating employer support for breastfeeding.

• Hold events (ceremonies, health fairs, new employee orientation, town hall meetings,

and other employee/public gatherings) where the worksite lactation support program is announced and promoted.

• Publish newsletters, email blasts, and Internet/intranet pages in which the worksite lactation support program is announced and promoted.

• Appoint a single point of contact such as a wellness coordinator or human resources specialist to coordinate the worksite breastfeeding support program. Include this role in

the employee’s job description.

• Provide easy-to-find information about available employee benefits to support breastfeeding employees, such as use of flexible spending accounts for breast pumps, lactation services made available through the employee health plan, flexible leave options (paid family leave, disability insurance, leave pool options, etc.), flexible scheduling options, breastfeeding and/or parenting classes, employee assistance program offerings relevant to parents, etc.

• An employer-purchased hospital-grade multi-user electric breast pump included as a feature in the employee lactation room (employees provide their own personal pump kits).

• Provide a dedicated refrigerator and/or personal coolers for storage of breastmilk.

• Provide incentives and/or recognition for breastfeeding employees, such as parental leave packets that include breastfeeding literature and information about your worksite lactation program, baby showers that promote exclusive breastfeeding, a “come-back pack” of educational materials and items that encourage exclusive breastfeeding, wellness incentive points, or other recognition for reaching breastfeeding milestones, etc.

• Seek employee and manager feedback and evaluate your program to ensure that the program is reaching its intended users and continues to meet their needs.

Provide resources to help employees who wish to combine working and breastfeeding with access to support from other mothers, informal support, and/or professional support as needed, including:

• Contact information for local International Board-Certified Lactation Consultants, lactation support group meetings, hotlines, parenting groups, and/or other community breastfeeding resources.

• A forum, blog, or other electronic networking opportunity for mother-to-mother

employee support.

• A bulletin board and/or notebook in the employee lactation space for breastfeeding employees to share pictures and notes of support with each other.

• Coordination of the worksite breastfeeding support program by a skilled lactation expert hired by the worksite.

• Facilities at the worksite for regular support group meetings.

• Access to an International Board Certified Lactation Consultant and/or breastfeeding peer counselor/educator as an employee benefit.

• Provide a return-to-work consultation by a Trained Breastfeeding Educator or an International Board Certified Lactation Consultant.

Provide management staff with:

• A clear directive from executive leadership to communicate and implement the worksite lactation support policy.

• Clear communication about expectations and processes by which the policy will be implemented across the worksite.

• Information about why worksite lactation programs are good for your business and aligned with management priorities, such as retention, reduced absenteeism, and increased focus, loyalty, commitment, and morale.

• Education about how to create a supportive environment for breastfeeding employees.

• Education about how to locate adequate and appropriate temporary or permanent lactation space.

• Tools to help the manager communicate and plan for scheduling needs of each lactating employee.

• Support and assistance for managing workflow concerns.

• Information, resources, and a point of contact to address employee questions or concerns that may arise.

• Seek employee and manager feedback and evaluate your program to ensure that the program is reaching its intended users and continues to meet their needs.

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Formal breastfeeding education for mothers and families results in increased breastfeeding success. Education that is combined with in-person or telephone support results in an even greater improvement in breastfeeding rates. The greatest increase in breastfeeding initiation, duration, and exclusivity is achieved when mothers receive both prenatal (occurring during pregnancy) and postpartum (occurring after the baby is born) education and support components.1, 2

Why is breastfeeding education so important?

Breastfeeding education provides families with the knowledge they need to:

Make informed infant-feeding decisions. Though most mothers understand that breastfeeding is the best choice for their infants, many do not have an understanding of the specific health risks that are reduced when breastfeeding occurs according to medical recommendations.3 Mothers who learn about the specific health benefits of breastfeeding are more likely to breastfeed.3, 4 Likewise, mothers are more likely to initiate breastfeeding when their babies’ fathers receive education about breastfeeding.5, 6

Set realistic expectations. There are many common beliefs and attitudes about the process of breastfeeding that can reduce breastfeeding success. For example, a common assumption among pregnant women is that breastfeeding is difficult or painful. Fear of pain is a common reason that women may choose not to try breastfeeding. Likewise, this misconception that pain or discomfort is a normal part of breastfeeding may prevent a woman who is having a difficult time with breastfeeding from seeking help. Education about breastfeeding during pregnancy can set realistic expectations for families about the normal course of breastfeeding, provide information about common complications, and give guidance about when and how to seek help if complications occur.

Learn the process and techniques to reduce complications and make breastfeeding easier. Though breastfeeding is a natural process, it is also a learned skill. Breastfeeding education includes demonstration of techniques and skills (e.g., holding, positioning, and latching the infant at the breast; learning about an infant’s hunger cues; and learning how to know that baby has had enough to eat), which can help families feel more prepared when their babies

are born. Involving fathers in breastfeeding educating by providing information and skills to support their partners can improve breastfeeding outcomes.7, 8

In addition to learning skills for breastfeeding a newborn infant, a woman who plans to return to work after childbirth benefits from learning about how to combine working and breastfeeding. She will need information about how to express and store milk, how to maintain her milk supply once she returns to work, and how to prepare her child’s caregiver to best support continued breastfeeding. Education that is provided both during her pregnancy and around the time she is preparing to return to work will give her the information that she needs at a time when it is most meaningful to her.

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In focus groups held across Texas to learn more about the need for Mother-Friendly Worksites, many working mothers who intended to combine working and breastfeeding talked about their real-life experiences after returning to work. Some mothers reported that their workplace had a supportive environment that helped them to comfortably balance their physical need to express breastmilk during the workday with meeting the responsibilities of their work. These mothers described how this support allowed them to have peace of mind and a feeling of balance because they were able to continue to provide for their child and maintain a connection through breastfeeding even during periods of separation. Because these needs were met during the brief breaks they took to express breastmilk, they described that they were able to provide full focus to their work throughout the workday. They also stated that this support reaffirmed their loyalty and commitment to their employer.

Some mothers reported very different experiences with managers and coworkers when they asked for accommodation of breastfeeding, ranging from negative attitudes or uncomfortable tension, to distasteful jokes and comments, to actions that directly impacted their employment or earnings.

Most mothers reported that they did not feel comfortable talking to their employer or coworkers about their need for lactation accommodation. Some reported feeling concerned about how their managers would react if they asked “for more time” for milk-expression breaks after the leave time they had taken after childbirth. They reported feeling concern that their need for breaks would be incorrectly perceived by their bosses or coworkers as a sign that they were doing less work or contributing less value to the organization than their non-breastfeeding team members. They also reported concern that asking for lactation accommodation would negatively impact their ability to move ahead in their careers or even put their jobs at risk.

Instead of asking for support, many of these women weaned—or stopped breastfeeding—before they went back to work. Others tried for a while—until their bodies stopped producing milk—to make do with only pumping milk before or after work or taking short sporadic milk-expression breaks in the bathroom or their cars. Still others left their jobs for more breastfeeding-friendly work environments. These mothers reported feeling stressed, torn in multiple directions, physically uncomfortable, and disappointed about their inability to provide their child with the health benefits of breastmilk and the closeness of the breastfeeding relationship for as long as they had wanted.

Worksite surveys reveal that many managers are also concerned about the attitudes and perceptions of their staff related to lactation breaks. The belief that coworkers may feel that lactation breaks are unfair is often seen by managers as a barrier to providing a supportive environment for lactating employees. While there may indeed be some vocal employees with negative attitudes toward worksite lactation support programs, breastfeeding, or parenting employees in general, studies demonstrate that the majority of the general public10 and

coworkers11 have positive views of and attitudes toward worksite lactation support services.

If coworkers have had previous exposure to employees who have combined working and breastfeeding, they are even more likely to have positive attitudes toward worksite lactation support. This remains true regardless of the coworker’s gender, length of employment, or personal breastfeeding experience.11

Establishing your worksite’s written employee breastfeeding policy is an important cornerstone in the foundation of a supportive workplace environment in which breastfeeding employees can feel confident in their ability to combine working and breastfeeding. The policy should be implemented and communicated in a way that fosters a positive, accepting attitude from upper management, supervisors, and coworkers. A well-communicated worksite lactation support policy can go a long way toward assuring that an employee’s most basic needs—the privacy and time to maintain milk production after returning to work—are met.

Comprehensive worksite lactation support programs often offer additional supports such as access to guidance and support from other mothers with breastfeeding experience (e.g., peer counselors), services from trained lactation professionals (e.g., International Board Certified Lactation Consultants, or IBCLCs), and employee benefits that support breastfeeding success. Access to WIC peer counselors12-15 and to IBCLCs16-17 are associated with improved breastfeeding duration and exclusivity. Businesses with comprehensive programs have been shown to experience significant cost savings associated with improved breastfeeding outcomes.

“Women can obtain helpful information about how to breastfeed from classes, books, online resources, and the U.S. Department of Agriculture’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), as well as from other mothers who have breastfeeding experience.”9

– Office of the U.S. Surgeon General

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Basic Overview

Chapter 5, Getting Started, of the National Business Group on Health’s publication, Investing in Workplace Breastfeeding Support: An Employer’s Toolkit includes a brief overview of the education and support components of a worksite lactation support program. The chapter includes basic ideas for activities that can address these components.

Support Resources

Resources to help you support your employees

Information for incorporating worksite lactation into a benefits program:

Investing in Maternal and Child Health: An Employer's Toolkit

National Business Group on Health

Presents strategies and tools to improve the health of children, adolescents, and women before, during, and after pregnancy. Provides a case study of a healthy pregnancy program, including incorporating a lactation support component, offered to employees at the Fortune 500 company AOL. Includes the Maternal and Child Health Plan Benefit Model, which includes coverage of lactation services and breast pumps.



Information for Supporting Traveling Employees:

Guidance from the US Department of Labor for the employer regarding the recommendation under the Fair Labor Standards Act to provide a space when their nursing employee is located off-site: “In situations where the employee is off-site, the Department recommends that the employer arrange with the client to allow the employee to use a space at the client’s site for the purpose of expressing milk.”

Breastfeeding Support at Conferences and Meetings, from Building Breastfeeding-Friendly Communities in Wisconsin, Wisconsin Department of Health Services:



Centers for Disease Control and Prevention (CDC): Traveling Information for the Nursing Mother:



Transportation Security Administration: Important Information on Traveling with Formula, Breast Milk, and Juice:

Information Related to Safe Handling and Storage of Breastmilk:

Proper Handling and Storage of Human Milk, CDC



Statement that breastmilk does not constitute occupational exposure as defined by regulation 29 CFR 1910.1030, “Occupational Exposure to Bloodborne Pathogens,” US Department of Labor Occupational Safety & Health Administration (OSHA)



Resources to Identify Peer Mother-to-Mother Support

Since each community has a different set of available resources, you will have to do some investigating. Good places to start include:

La Leche League of Texas. Provides information about local La Leche League chapters for mother-to-mother support:

Baby Cafes. Informal café-like drop-in centers where breastfeeding moms and/or their partners can come with their babies to get support from other mothers and/or from specially trained breastfeeding staff:

The Texas Department of State Health Services Women, Infants and Children Program is an income-based nutrition program that helps pregnant women, new mothers, and young children eat well, learn about nutrition, and stay healthy. WIC provides nutrition education and counseling, nutritious foods, and help accessing health care for low-income women, infants, and children. WIC clients are eligible to receive breastfeeding education and support, including mother-to-mother support, through the WIC Peer Counselor Program.

For information on WIC eligibility, locations, and services:

For information about the WIC Peer Counselor Program:

DSHS Peer Counselor Training Workshop. This course prepares attendees to develop a peer counselor program and train peer counselors to provide skilled mother-to-mother support. Consider sending an employee to this course to develop a peer-counselor initiative within your worksite:

Resources to Identify Professional Support:

Information and Referral Helplines:

Texas Statewide Lactation Support Hotlines:

• 800-514-6667

• 877-550-5008

• 855-550-6667



Online Texas Lactation Directory



Office on Women’s Health National Breastfeeding Helpline:

• 800-994-9662



Clinical Lactation Support:

WIC Lactation Training and Resource Centers: Any family in Texas that is eligible for the WIC program may receive professional lactation support, free of charge, at lactation clinics in Austin, Dallas, and Houston.

Mom’s Place

8701-B Research Boulevard (Hwy 183)

Austin, TX 78758

512-719-3010

Toll free: 800-514-6667 (Leave a message after hours. Calls will be returned within 24 hours.)

Email: MomsPlace@ci.austin.tx.us



Lactation Care Center

2600 North Stemmons Freeway

Suite 188

Dallas, TX 75207

214-670-7222

Toll free: 855-550-6667

Email: LactationCareCenter@



Lactation Foundation

2636 South Loop West #135

Houston, TX 77054

713-839-0527

Toll free: 877-550-5008

Email: Lactation.Foundation@uth.tmc.edu





ILCA directory: A public directory of ILCA members who are International Board Certified Lactation Consultants:

Contact your local hospitals and clinics to see what lactation support resources they

may offer.

Community Support for Breastfeeding

Organizations that share the mission to improve health by working collaboratively to protect, promote, and support breastfeeding:

United States Breastfeeding Committee:

Texas Breastfeeding Coalition:

Local Breastfeeding Coalitions:

State and National Policies Related to Breastfeeding

• US Department of Labor Break Time for Nursing Mothers:

o Comprehensive Information Page:

o Preliminary Interpretation/ Request for Information:

• Texas Health and Safety Code 165, Breastfeeding:

• Texas Health and Safety Code 161.071, Minimum Guidelines for Human Donor Milk Banks:

• Texas Health and Safety Code 115.009, Early Childhood Nutrition and Physical Activity Plan:

• Texas Insurance Code 1366 Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care:

• Listing of Federal and State Breastfeeding Laws, National Conference of State Legislators:

• Texas Department of State Health Services Position Statement on Infant Feeding:

• National Policies, Position Statements, and Initiatives on Breastfeeding:

o

o

o

Information for Employees to Share with their Child-Care Providers

• A free online continuing education course for child-care providers, Supporting Breastfeeding in the Child Care Setting, was developed with support from DSHS and is offered by Texas AgriLife Extension:

National Resource Center for Health and Safety in Child Care and Early Education Website:



• Includes guidance on promotion of breastfeeding in the child-care setting in these publications:

o Preventing Childhood Obesity in Early Care and Education Programs

o Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs

• Ten Steps to Breastfeeding-Friendly Child-Care Centers Resource Kit. A resource kit from the Wisconsin Department of Health Services to assist child-care providers and community groups to implement strategies to promote, protect, and support breastfeeding women. The kit includes a self-appraisal tool and information and resources for planning and implementing an action plan based on the 10 steps. Child-care center staff can earn continuing education units:

• How to Support a Breastfeeding Mother: A Guide for the Child-Care Center, Texas DSHS WIC Nutrition:

• Information on How to Bottle-Feed the Breastfed Baby:

• Management of Human Milk in Child-Care Settings, California Department of Public Health:

• What to Do if an Infant or Child is Mistakenly Fed Another Woman’s Expressed Breastmilk, Centers for Disease Control and Prevention:

Resources for Parents of Preterm Infants, Twins, and Other Special Circumstances, Including Mothers Who Are Ill or Are Taking Medications

Relevant pamphlets for order or download from the DSHS WIC Catalog:

• Late Preterm Infant Care

• Mother's Milk For Premature Babies

• Nursing More Than One

Web-based Resources:

• Getting Started with Breastfeeding: Includes online videos, information about care of babies at risk, and other informational resources from Stanford School of Medicine:

• Moms of Multiples:

• Breastfeeding After Breast and Nipple Surgeries, BFAR Information and Support:

• Low Milk Supply Information and Support for Breastfeeding Mothers:

• Breastfeeding Babies with Special Needs, La Leche League International:

• Information from the Centers for Disease Control and Prevention about Breastfeeding and Specific Diseases of Conditions:

• Information from the Centers for Disease Control and Prevention about Vaccinations and Breastfeeding:

• Texas Tech University Health Science Center Infant Risk Center. Provides evidence-based information to professionals and the general public about the use of medications during pregnancy and breastfeeding:

Donor Milk Banks

Nonprofit donor human milk banks accept, pasteurize, and dispense donor human milk by physician prescription, primarily to premature and ill infants. If a mother is unable to provide any or enough of her own breastmilk, banked donor breastmilk is the next best source of nutrition. Because the milk is species-specific, it promotes growth and health and protects fragile infants against necrotizing enterocolitis, a debilitating disease common in preterm infants.

Human Milk Banking Association of North America (HMBANA) The Human Milk Banking Association of North America (HMBANA) is a multidisciplinary group of health-care providers that promotes, protects, and supports donor milk banking. HMBANA is the only professional membership association for milk banks in Canada, Mexico, and the United States and as such, sets the standards and guidelines for donor milk banking for those areas:

Texas HMBANA Milk Banks

Mothers' Milk Bank at Austin

2911 Medical Arts St. Suite 12

Austin, TX 78705

Phone (512) 494-0800

Toll-free 1 (877) 813-MILK (6455)

FAX (512) 494-0880



info@

Mothers' Milk Bank of North Texas

1300 W. Lancaster Suite 108

Ft. Worth, TX 76102

Phone (817) 810-0071

Toll-free 1 (866) 810-0071

FAX (817) 810-0087



info@

Education Resources:

Online General Breastfeeding Education and Support Resources to provide in a printed list format or to link to your organization’s intranet:

• Texas Department of State Health Services/Texas WIC One-Stop Breastfeeding Resource:



• Texas WIC Online Classes:



• US Office on Women’s Health Breastfeeding Information:



• Centers for Disease Control and Prevention’s Breastfeeding Recommendations:

• American Academy of Pediatrics’ website, :

• : Breastfeeding and parenting information from an IBCLC:

• La Leche League, International: A not-for-profit organization whose mission is “to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.”:

• Best for Babes Foundation: A not-for-profit foundation whose mission is “to change the cultural perception of breastfeeding and to beat the Booby Traps™—the cultural and institutional barriers that prevent moms from achieving their personal breastfeeding goals (whether that’s two days, two months or two years) without judgment, pressure, or guilt.”

• Black Mother’s Breastfeeding Association: A nonprofit organization whose objective is to provide education, valuable resources, and ongoing support to breastfeeding mothers, their families, and the African-American community.

See educational web resources specific to worksite lactation in Step 8, Resources List

Print and Audio/Visual Resources

Providing access to written or visual information is a simple, low-cost way to provide educational support. Materials can include educational books, pamphlets, and DVDs specific to breastfeeding and combining work and parenthood. You might also include brochures and pamphlets that provide general health tips and information about community resources. If you have designated space for a lactation room, then you can store materials there. Otherwise, you can create a lending library and allow employees to check out materials. You may also hand out materials when an employee is leaving for parental leave or returning to work. Including links from your intranet page is another way to provide easy access to useful information for your employees.

Freely Available Resources

From the Texas Department of State Health Services:

• The Texas WIC Catalog includes many brochures, flyers, handouts, posters, forms, training materials, music CDs, informational DVDs, and related items. Many items are available for order in limited quantities and/or are in a printable format; DVDs and CDs are available for the cost of reproduction.

Browsing Tips: Click on Browse, then on Main Menu: View Catalog Items. To see all items offered through the catalog or items in a selected category, use the toolbar at the top of the catalog to move from page to page or to increase the number of items that can be viewed per page:

• The DSHS Audiovisual Library consists of video (DVD, VHS), slides, tapes, audio CD, and

CD-ROM programs on health and safety education topics. These materials are available on

a free-loan basis (up to 10 days) to residents of the state of Texas and can be delivered by mail:

From the US Office on Women’s Health:

• “Business Case for Breastfeeding” Toolkit. Includes “Employee’s Guide to Breastfeeding” brochure, promotional flyers, promotional table tents, drop-in newsletter communication, lactation support feedback forms, etc.:

• “Your Guide to Breastfeeding.” Offered in multiple languages, provides how-to information for women to breastfeed successfully:



• “Breastfeeding: Frequently Asked Questions” Fact Sheet:

From the US Department of Agriculture’s WIC Loving Support Learning Center

• Breastfeeding Promotion Materials:

Additional Recommendations for Print or Audio-visual Educational Resources:

• Texas WIC :

• La Leche League Book Evaluation Committee Annotated Bibliography:

• New Hampshire Breastfeeding Resource Guide:

Resources for Formal Education Offerings:

Below are some resources to identify community education offerings and/or to develop educational offerings to host at your worksite.

Questions to consider when choosing classes to offer or recommend to your employees:

o What are the qualifications of the instructor?

o Does the instructor have any potential conflicts of interest?

o Does the instructor speak to cultural issues relevant to your employee population?

o What are the class objectives, outline, and content?

o Are the classes breastfeeding-specific, or do they also provide general parenting or childbirth preparation information?

o Can the classes be offered onsite or at a nearby location?

o Will employees need to take time off to attend classes?

o How will employees be reimbursed for class registration fees?

o What paperwork is necessary to enroll in the classes?

o How many employees do you expect to attend?

o Will you allow/sponsor partners of employees to participate?

Once you have determined the basic needs and structure of your program, you can look for a qualified instructor who will be able to meet those needs. If your organization employs a health or wellness expert, they may already have some expertise to prepare them to offer the classes. If staff members do not already have breastfeeding education expertise, you may consider sponsoring them to complete low-cost trainings offered through the Texas Department of State Health Services so that they are prepared as Trained Breastfeeding Educators.

You may also consider contracting for instructors to offer onsite classes or choose to recommend classes that are offered in your community. To find appropriate instructors in your geographical area, consider contacting the International Lactation Consultant Association (ILCA), your local breastfeeding coalition, La Leche League, your local WIC clinic, and your local hospitals.

Resources for Training or Locating an Instructor

Texas DSHS-Trained Breastfeeding Educator Program. A DSHS-Trained Breastfeeding Educator possesses a certificate stating they have successfully completed the courses Principles of Lactation Management (POLM) and Lactation Counseling and Problem Solving (LCAPS) and can answer basic breastfeeding questions on anatomy of the breast, evaluate and assist moms with latching, and identify successful breastfeeding. By having the TBE designation, you are more knowledgeable in the area of lactation and are able to assist with basic breastfeeding education:

Accreditation and Approval Review Committee (AARC) on Education in Human Lactation and Breastfeeding. Recognizes educational programs that meet the minimum standards of quality to prepare individuals to enter the lactation consultant profession:

The International Lactation Consultant Association (ILCA). Provides an online directory of its members who are International Board Certified Lactation Consultants and who assist businesses with worksite lactation support programs:

These IBCLCs can help with:

• Training for your supervisors and employees.

• One-on-one lactation consultations for breastfeeding employees.

• Classes and support group meetings.

• Advising on appropriate breast pump equipment to purchase or rent.

• Recommending or helping you develop educational resources.

• La Leche League of Texas. Provides information about local La Leche League chapters:

• The Texas Department of State Health Services Women, Infants and Children Program. An income-based nutrition program that helps pregnant women, new mothers, and young children eat well, learn about nutrition, and stay healthy. WIC provides nutrition education and counseling, nutritious foods, and help accessing health care to low-income women, infants,

and children. WIC clients are eligible to receive breastfeeding education and support, including mother-to-mother support through the WIC Peer Counselor Program.

• Texas Hospital Association Texas Hospital Directory:

List of Steps for Planning the Class:

• Develop or adapt a course outline.

• Determine the length of each class and whether one class or a series of classes will be offered.

• Determine how frequently you will offer the class.

• Determine the size, seating capacity, and availability of the classroom.

• Determine the cost of each class, if any, per person or per couple.

• Purchase or develop appropriate audiovisual materials, props, equipment, etc.

• Prepare handouts and/or supporting resource packets.

• Promote the class via email, newsletter, intranet, signage, etc.

• Develop an evaluation tool to receive feedback about the class and any revisions needed.

• Give yearly reviews and updates for instructors regarding breastfeeding.

Sample Lesson Plans:

The Health and Human Services Business Case for Breastfeeding Toolkit, Outreach Marketing Guide Reproducible Resources (pages 13-26) includes sample lesson plans for a two-course series, including (1) Preparing for Baby and (2) Back to Work.

Sample Promotional Flyer to Announce the Employee Breastfeeding Classes:



References:

1 Palda VA, Guise JM, Wathen CN (Canadian Task Force on Preventive Health Care). Interventions to promote breastfeeding: applying the evidence in clinical practice. CMAJ. 2004;170(6):976-8.

2 Chung M, Raman G, Trikalinos T, Lau J, Ip S. Interventions in primary care to promote breastfeeding: An evidence review for the US Preventive Services Task Force. Ann Intern Med. 2008;149(8):565-82.

3 McCann MF, Baydar N, Williams RL. Breastfeeding attitudes and reported problems in a national sample of WIC participants. J Hum Lact. 2007;23(4):314-24.

4 Di Girolamo A, Thompson N, Martorell R, Fein S, Grummer-Strawn L. Intention or experience? Predictors of continued breastfeeding. Health Educ Behav. 2005;32(2):208-26.

5 Arora S, McJunkin C, Wehrer J, Kuhn P. Major factors influencing breastfeeding rates: Mother’s perception of father’s attitude and milk supply. Pediatrics.2000;106(5):E67.

6 Bar-Yam NB, Darby L. Fathers and breastfeeding: A review of the literature. J Hum Lact. 1997;13(1):45–50.

7 Wolfberg AJ, Michels KB, Shields W, O’Campo P, Bronner Y, Bienstock J. Dads as breastfeeding advocates: Results from a randomized controlled trial of an educational intervention. Am J Obstet Gynecol. 2004;191(3):708–12.

8 Pisacane A, Continisio GI, Aldinucci M, D’Amora S, Continisio P. A controlled trial of the father’s role in breastfeeding promotion. Pediatrics. 2005;116(4):e494–8.

9 US Department of Health and Human Services. The Surgeon General’s call to action to support breastfeeding. Washington, DC: US Department of Health and Human Services, Office of the Surgeon General; 2011. Pg. 38.

10 Texas Department of State Health Services. Texas Behavioral Risk Factor Surveillance System. 2009.

11 Suyes K, Abrahams SW, Labbok MH. Breastfeeding in the workplace: Other employees’ attitudes towards services for lactating mothers. Int Breastfeed J. 2008;3:25.

12 Olson BH, Haider SJ, Vangjel L, Bolton TA, Gold JG. A quasi-experimental evaluation of a breastfeeding support program for low income women in Michigan. Matern Child Health J. 2010;14(1):86–93.

13 Yun S, Liu Q, Mertzlufft K, Kruse C, White M, Fuller P, Zhu BP. Evaluation of the Missouri WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) breastfeeding peer counselling programme. Public Health Nutr. 2010;13(2):229–37.

14 Anderson AK, Damio G, Young S, Chapman DJ, Pérez-Escamilla R. A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community. Arch Pediatr Adolesc Med. 2005;159(9):836–41.

15 Chapman DJ, Damio G, Young S, Pérez-Escamilla R. Effectiveness of breastfeeding peer counseling in a low- income, predominantly Latina population: A randomized controlled trial. Arch Pediatr Adolesc Med. 2004;158(9):897–902.

16 Bonuck KA, Trombley M, Freeman K, McKee D. Randomized, controlled trial of a prenatal and postnatal lactation consultant intervention on duration and intensity of breastfeeding up to 12 months. Pediatrics. 2005;116(6):1413–26.

17 Castrucci BC, Hoover KL, Lim S, Maus KC. A comparison of breastfeeding rates in an urban birth cohort among women delivering infants at hospitals that employ and do not employ lactation consultants. J Public Health Manag Pract. 2006;12(6):578–85.

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