Breastfeeding: A community Health initiative Paulina Erices, BS, IBCLC, RLC

Objectives After this session participants will be able to: Identify breastfeeding health benefits for mother, child, and society. Understand breastfeeding basics. Recognize situations that should be referred to a breastfeeding specialist. Understand the challenges of breastfeeding in special situations.

American academy of pediatrics “The American Academy of Pediatrics believes that breastfeeding is the optimal source of nutrition through the first year of life.” “We recommend exclusively breastfeeding for about the first six months of a baby's life, and then gradually adding solid foods while continuing breastfeeding until at least the baby's first birthday. Thereafter, breastfeeding can be continued for as long as both mother and baby desire it.” (www.healthychildren.org)

World Health organization Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond. “Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large.” (www.who.org)

Colorado Statistics Initiation rates: 88.6 Breastfeeding at 3 months: 66.2 Breastfeeding at 6 months: 40.6 Exclusive Breastfeeding at 3 months: 57.3 Exclusive Breastfeeding at 6 months: 26.4

Breastfeeding Friendly Environments Baby Friendly Hospital Initiative 9 designated CBFHC 14 more working on it Breastfeeding Laws Workplace Accommodations for nursing mothers Jury Duty laws Breastfeeding in public laws Breastfeeding friendly childcare recognitions

Breastfeeding is a “gateway solution” Feeding is the most stressful aspect of parenting Once established-easier lifestyle Feeding leads to attachment and bonding opportunities Infant and maternal mental health Maternal hormonal regulation Infant illness prevention SIDs prevention Benefits are cumulative Financial benefit

What can you do?

Breastfeeding basics Colostrum and mature milk When the milk comes in Composition changes Diet and fluid intake Illness Medications and herbs Side effects in mothers Normal developmental periods Safe sleep Establishment of routines? Breastfeeding experts info IBCLC- CLC- LLL- BFUSA

Breastfeeding First Aid guide Risk factors Prematurity or multiples Cesarean birth or long difficult birth Mom has a history of abuse Maternal mental illness Substance abuse Mood disorders Infant medical conditions Lack of support at home Inconsistent healthcare- lack of medical home

Red Flags MOM: shows signs of anxiety or depression Mom cannot sleep even when baby is sleeping complains of breast or nipple pain complains of not making enough milk uses a nipple shield or pumps exclusively has no support at home BABY is sleepy and is hard to wake up to feed has less than 6-8 wet, 3-4 soiled diapers a day doesn’t gain weight Babies gain between 5-7 oz a week in the first 3 months

Premature and medically fragile infants Parental role attainment Transition NICU-Home Maternal wellbeing and social/family support What you NEED to know: Adjusted/corrected age Asynchrony development/milestones High risk of maternal and paternal mental illness Information and support for siblings and grandparents Coordination of care is needed Referral to HCP for children and youth with special health care needs.

Konnect mom Mother support Involve a specialist Long-term impact Action steps Mother support Validate mothers feelings Involve a specialist Contact an IBCLC – www.ilca.com NFP- Prenatal Plus - WIC Long-term impact Feeding as development Celebrate small steps Konnect mom Find a peer-support group

Organizations in the community Colorado Breastfeeding Coalition – Advocacy La Leche League Groups – Free, peer support Breastfeeding USA Groups- Free, peer support Bada…. Breastfeeders (Facebook groups) – Free, moderated online peer support group) WIC (for eligible families) Home visitation programs through the Health Department (for eligible families) Special Kids, Special Care (for families with medically fragile or premature infants) Rooting for Mom – Insurance pre-approval for IBCLC services Mothers Milk Bank – Human Milk Bank

Conclusion Breastfeeding is important for infant development and families' wellbeing. Breastfeeding presents challenges. Connecting families with the resources, information, and support is essential for their success. Breastfeeding promotion and support is a community health initiative. Everybody can do something to support families with young children, so they can reach their own breastfeeding goals.

Paulina Erices, BS, IBCLC, RLC Contact Information Paulina Erices, BS, IBCLC, RLC HCP for Children and Youth with Special Healthcare Needs Jefferson County Public Health Department perices@jeffco.us 303-239-7063

References American Academy of Pediatrics www.aap.org World Health Organization www.who.org La Leche League International www.llli.org Breastfeeding USA www.bfusa.org American Congress of Obstetricians and Gynecologists www.acog.org Special Kids Special Care www.specialkids- specialcare.org International Lactation Consultants Association www.ILCA.org