1. Massachusetts Department of Public Health: 2017 Breastfeeding Updates
Ellen Tolan RD, LDN, IBCLC
Massachusetts WIC
State Breastfeeding Coordinator

2. I have no actual or potential conflict of interest in relation to this presentation

3. Objectives Share Massachusetts breastfeeding data and accomplishments
Discuss MDPH initiatives and collaborative efforts
Discuss how WIC and birth hospitals can work together to improve breastfeeding outcomes

4. CDC Breastfeeding Data
Region
Ever
Breastfed
Breastfeeding at 6 months
Breastfeeding at 12 months
Exclusive breastfeeding at 3 months
Exclusive breastfeeding at 6 months
U.S. National
82.5%
55.3%
33.7%
46.6%
24.9%
Massachusetts
89.2%
65.2%
43.0%
52.8%
29.6%
(from 2016 CDC Report Card)
87.4%
67.9%
38.7%
49.2%
19.9%
Healthy People
2020 Target
81.9%
60.6%
34.1%
46.2%
25.5%
Massachusetts WIC FY16’
80.9%
28%
------
14%
11%
The Centers for Disease Control and Prevention released data from the National Immunization Survey, which reflect breastfeeding practices based on 2014 births. Massachusetts continues to be a top performer in all targets nationwide. To read the full report log onto cdc.gov/breastfeeding/data (link provided)

5. 2015 CDC Breastfeeding mPINC Data
Maternity Practices in Infant Nutrition & Care Massachusetts Ranked 5th in the nation! For more info:
Survey (every 2 years) to birth hospitals to assess progress in different areas:
L&D, Feeding of Breastfed Infants, Breastfeeding Assistance, Contact between mother and infant, Hospital Discharge Care, Staff Training, Structural & Organizational Aspects of Care Delivery.

6. 20% of Massachusetts Hospitals Now Baby-Friendly
Boston Medical Center
Cambridge Birth Center
Emerson Hospital
Fairview Hospital
Good Samaritan Hospital
Holyoke Medical Center
Martha’s Vineyard Hospital
Massachusetts General Hospital
Melrose-Wakefield Hospital
Tobey Hospital
16 Hospitals on the Pathway to Baby Friendly  
10 out of 48 Birthing Facilities now Baby Friendly

7. MDPH Activities in 2017 Birth Hospital Speaker Series
NeoQIC Human Milk Quality Improvement Collaborative
Massachusetts Breastfeeding Coalition
MA Baby Friendly Hospital Collaborative
Boston Breastfeeding Coalition/Vital Village Network
Becoming Baby Friendly Toolkit Updates
Breastfeeding CME for required BFHI training for MDs
Readiness Assessment to St. Luke’s Hospital
Early Intervention Partnerships Program and MA Home Visiting Programs enhance breastfeeding support services

8. MDPH Birth Hospital Speaker Series
MDPH was awarded a grant from the Center for Disease Control and Prevention to support implementation of population-wide approaches to prevent obesity, diabetes, heart disease and stroke, and to reduce health disparities in these areas.
One of the strategies under this grant is to support hospital breastfeeding initiatives.
Funding allowed 7 birth hospitals in 2017 to receive this opportunity, which targets the needs of medical staff directly.
Presentation formats included Grand Rounds, staff meetings and Lunch and Learn sessions.
In January/February 2017 sent out information via Baby Friendly Hospital Collaborative list-serve to announce the opportunity. Received 8 applications. 7 were awarded.

9. Birth Hospital Speaker Series 2017
Baby Friendly Hospital Initiative- Frequently Asked Questions for Physicians
Barbara L. Philipp MD, FAAP, FABM
Promoting Safe Skin to Skin or Physician Education around Baby Friendly Practices
Lauren E. Hanley, MD, FACOG, IBCLC
Quality Improvement (QI) requirements for Baby Friendly Hospital Initiative
Mary Ellen Boisvert, MSN, RN, CLC, CCE, Six Sigma Black Belt
Beth Israel Deaconess Plymouth
Mercy Medical Center
Nantucket Cottage Hospital
Sturdy Memorial Hospital
Morton Hospital
Charlton Memorial Hospital
Winchester Hospital

10. MDPH Division of Pregnancy, Infancy and Early Childhood
MA Maternal, Infant and Early Childhood Home Visiting
Monitors breastfeeding as part of federal benchmark
Offered CLC training to home visitors in FY 16
Welcome Family
Universal one-time Home Visit(90 minute)from experienced public health nurses-CLCs and IBCLCs
Visit conducted 2-8 weeks postpartum(aiming at 2 weeks)
Available in Boston, Fall River, Holyoke, Springfield, Lowell
health/new-parent-initiative/welcome-family-information-for-families.html
Early Intervention Partnerships Program
Increased home visits, support groups, individual lactation support within the first few weeks postpartum
Cross cutting initiatives within our Bureau (BFHN)

11. Becoming Baby Friendly Toolkit

12. Breastfeeding CME

13. NeoQIC Human Milk Quality Improvement Collaborative
10 Level 3 NICUs and partners working to increase utilization of Mother’s own milk and PHDM to VLBW babies

14. Anna Jaques Hospital Northern Essex WIC
2017 Focus Area:
“Birthing Facilities That Have Active Partnerships with Local WIC Programs”
Anna Jaques Hospital Northern Essex WIC
Melrose-Wakefield Hospital North Suburban WIC
Lowell General Hospital Lowell WIC
Massachusetts General Hospital Chelsea/Revere WIC
North Shore Medical Center North Shore WIC
Mercy Medical Center Springfield North WIC
Sturdy Memorial Hospital Taunton/Attleboro WIC
Charlton Memorial Hospital Fall River WIC
Milford Regional Medical Center South Central WIC
Good Samaritan Hospital Brockton WIC
Health Alliance Hospital-Leominster North Central WIC
Boston Medical Center Roxbury/South End WIC
St. Vincent Hospital Worcester WIC
MetroWest Medical Center Framingham/Waltham WIC
St. Luke’s Hospital New Bedford WIC
We reach out to Nurse Managers and through our MA Baby Friendly Hospital Collaborative (MDPH is an active partner) to promote the awards each year. The focus areas change each August. Some of our past areas include: “Employee Lactation Support” (2015), “Skin to Skin in the OR post Cesarean Section” (2014), “Commitment to The Baby Friendly 4-D Pathway” (2013), and “Breastfeeding Support Groups” (2012).

15. Utilize WIC for Steps 3 & 10!
Breastfeeding education and counseling to all women is a requirement during prenatal enrollment
Each WIC programs has a breastfeeding peer counseling program
25 WIC IBCLCs available and over 100 CLCs
Assistance in planning to return to work/school
Assistance in accessing breast pumps
Support groups and classes available at many programs
Generous food package for exclusively breastfeeding dyad 
We know that around 45% of WIC moms enroll in their first trimester. This is the best time to start discussing breastfeeding!

16. FY17 MA WIC Breastfeeding Peer Counselor Program Achievements
84 peer counselors worked with WIC mothers statewide at all 31 local WIC agencies.
Languages: English, Spanish, Portuguese, Chinese, Vietnamese, Arabic, Russian, Haitian Creole and American Sign Language.
Local WIC Programs Reported:
> 24,000 referrals made to the PC program
Made almost 35,000 completed calls and nearly 37,000 attempted calls
Sent almost 3,800 s and 22,000 text messages to participants
Provided almost 7,000 individual appointments
Provided 1100 prenatal groups and 620 breastfeeding support groups
Facilitated 220 Happiest Baby on the Block groups
Made 420 hospital visits
FY17 MA WIC Breastfeeding Peer Counselor Program Achievements

17. FREE Prenatal Education Material
Available for WIC Programs and Birth Hospitals
Best to distribute during pregnancy (initial prenatal visit)
Also can be provided in discharge packet

18. FREE Prenatal Education Material
Provides information on what to expect in the hospital
Educates women on practices that get breastfeeding off to a good start!
“Rooming In, Skin to Skin, Exclusive Breastfeeding”
Ellen Tolan directly to place order: