Breastfeeding Assessment, Education & Support
Breastfeeding is ideal for newborn infants and their mothers and is specifically designed to meet an infant’s nutritional and social-emotional needs.1-3 Aside from its highly digestible properties and delicate nutrient balance, breast milk has been found to impart immunity by transferring antibodies from mother to infant.1, 3 As a result, breastfed infants experience fewer emergency room visits, respiratory, urinary and ear infections, bacterial meningitis, and fewer occurrences of other diseases such as diarrhea, asthma, and lower rates of Sudden Infant Death Syndrome.1, 3 Further benefits for the infant include: increasing infant cognitive function, promoting the proper development of teeth and speech patterns, and decreasing the risk of later childhood obesity.1 Breastfeeding also has multiple benefits for the mother, including: enhancing the bond between infant and mother, decreasing recovery time following birth, enhancing maternal self-esteem, reducing the risks of certain cancers, and increased bone density.4,5 Breastfeeding Priorities and RecommendationsThe American Academy of Pediatrics (AAP) is joined by the Surgeon General and many domestic and international agencies in recommending breastfeeding as the best way to feed infants. The AAP recommends that infants breastfeed exclusively for the first six months of life and, with the addition of appropriate complementary foods starting at six months, breastfeeding should continue until at least one year of age, and thereafter for as long as both mother and child desire. The U.S. Healthy People 2020 national objectives for breastfeeding are to increase the proportion of mothers who breastfeed their babies
In addition, the Healthy People 2020 goals include
* Source: Centers for Disease Control and Prevention, National Immunization Survey, 2006 data.41
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Policy Statements & Recommendations
- American Academy of Breastfeeding Medicine Position Statement on Breastfeeding (PDF)
- American Academy of Pediatrics
- American College of Obstetricians and Gynecologists
- American College of Nurse Midwives (PDF)
- American Academy of Family Physicians
- U.S. Preventive Services Taskforce
- California Department of Public Health
- Practice Applications from the Surgeon General: Mothers and Children Benefit from Breastfeeding—Rear Admiral Steven K. Galson (2008)(PDF)
- HHS Blueprints and Breastfeeding Policy Statements
- Surgeon General's Call to Action to Support Breastfeeding 2011
- Federal law "Reasonable Break Time for Nursing Mothers" fact sheet
- United States Breastfeeding Committee Statement on Lactation Accomodations in the Workplace (2011) (PDF)
Practice Guidelines
Breastfeeding Support: Prenatal Care Through the First Year, Second Edition. Evidence-Based Clinical Practice Guideline. 2007 Developed by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) this document presents concise recommendations and supporting evidence for breastfeeding education and support during prenatal care, around the time of birth, the immediate postpartum period, and through infancy. Guidelines may be purchased through AWHONN.
ACOG Clinical Review. January-February 2007. Breastfeeding: Maternal and Infant Aspects. Special Report from ACOG Committee on Health Care for Underserved Women, Committee on Obstetric Practice. (PDF)
This document outlines the importance of breastfeeding, describes the benefits to mother, infant, family and society, and provides an overview of topics with which healthcare providers should become familiar in order to provide accurate information to the women in their care.
Academy of Breastfeeding Medicine: Educational Objectives and Skills for the Physician with Respect to Breastfeeding (2011) (PDF) |
Academy of Breastfeeding Medicine Clinical Protocols in multiple languages: Topics include
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Countermarketing and the WHO International Code of Marketing of Breast-Milk Substitutes Provides rational, evidence and guidelines for professionals working with mothers and infants on standards for marketing and distribution of infant formula. The guidelines were created by the World Health Organization in response to the negative impact on breastfeeding that results from direct marketing of formula to mothers. (PDF) |
US Breastfeeding Committee: Core Competencies in Breastfeeding Care and Services for All Health Professionals (2010) (PDF) |
Guidelines for evaluating pamphlets, audiovisuals, posters, handouts, and other media related to breastfeeding. Provides tips to evaluate any media used to promote and support breastfeeding and provides a worksheet to “score” media. |
Reimbursement for Lactation Services
Supporting Breastfeeding and Lactaction: Primary Care Pediatricians Guide to Getting Paid (PDF)
Forms
Prenatal Breastfeeding Assessment: Commonly used prenatal forms such as ACOG, and U.S. General Services Administration have space to record “Breast or Bottle”. POPRAS and the California Comprehensive Perinatal Services Program forms add information about prior pregnancy and planned duration of breastfeeding. Providers may benefit from having a form that provides additional “prompts” or questions to assess knowledge of breastfeeding benefits, attitudes and beliefs about breastfeeding, past experience, potential contraindications and intention, as presented in current guidelines.5 Supplemental forms need to be supplied to providers to assist in completing a comprehensive breastfeeding assessment. |
Prenatal Breastfeeding Assessment Tool Example: A form that can be adapted for use in your clinic to assess breastfeeding knowledge, attitudes, beliefs and intentions. At the onset of prenatal care. The UNICEF Baby Friendly Initiatvie provides a checklist for educational topics to cover towards the end of pregnancy |
Quality Improvement Tools
Tracking your results Prenatal BF Assessment Tracking 3-5-09.xls
Example of a form for tracking the number of clients receiving recommended breastfeeding assessments.
Toolkits
Hospital and Workplace Breastfeeding Support California Model Hospital Breastfeeding Policies Toolkit (2007) The California Department of Public Health developed this toolkit to assist hospitals and healthcare providers to meet the state and national public health breastfeeding goals. The toolkit includes resources and web links to materials that may be customized for individual use, with proper attribution to the original authors. The CDC Guide to Breastfeeding Interventions (2005): This guide reviews evidence-based and promising practices that support the initiation of breastfeeding in hospital settings and maintaining lactation once women return to school or work. The CDC Lactation Support in the Workplace (2007): This toolkit provides an example of how the CDC planned, implemented and evaluated a comprehensive workplace lactation support program. |
LA Best Babies Network Breastfeeding Friendly Workplace Policy This brochure outlines the rationale, benefits, and importance of developing a workplace policy that supports lactation at the workplace; a sample policy is included. The brochure is also available in Spanish. The Business Case for Breastfeeding -U.S. Department of Health and Human Services provides a series of materials including a toolkit with reproducible resources designed to create a breastfeeding friendly work environment. |
Lactation Counseling Training Programs
Los Angeles Area Lactation Counseling Training Programs:
- Breastfeeding Education @ UCSD
- UCLA Extension Lactation Education/Lactation Consultation Training Course
Provider & Family Breastfeeding Education
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Links to educational material for mothers and family members
Handouts and Fact Sheets
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Resources
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Lactation Services
Publications
- Investing in California’s Future (2007)- this is the second report from California Breastfeeding Promotion Advisory Committee outlining recommendations and strategies to increase exclusive breastfeeding in California.
- Normal Infant Feeding (2006) - Chapter 9 in California Food Guide - Provided by the Department of Public Health, the Food Guide is primarily designed for health professionals as a training manual.
- Breastfeeding Programs and Support Systems in Los Angeles County: A Needs Assessment
Report to First 5 LA, prepared by W. Slusser and L. Lange and the UCLA Center for Healthier Children, Family and Communities. August 2002
Breastfeeding Statistics
- California WIC 2011 Hospital Breastfeeding Rate Report
- California in-hospital infant feeding practices
- LA Health – Breastfeeding Practices County of Los Angeles Department of Public Health, March 2004
- CDC Breast Feeding Report Card - August 2008
Links
- California Department of Public Health
- Academy of Breastfeeding Medicine
- American Academy of Family Physicians
- American College of Obstetricians and Gynecologists
- American Academy of Pediatrics
- American College of Nurse Midwives
- California WIC Breastfeeding page
- Centers for Disease Control and Prevention
- LA Best Babies Network's Perinatal Indicator: Breastfeeding
- La Leche League International
- Office on Women's Health
- Wellstart International
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