1. Breastfeeding Support for the Community

2. Introductions ISDH-Indiana WIC Director
Sara Renner, MPH, MBA
ISDH-Indiana WIC Breastfeeding Coordinator
Crystal Fowler, RN, BSN, IBCLC

3. Background on WIC Started over 40 years ago Funded & guided by USDA
Indiana has 41 agencies, 138 clinic sites
50% clients are children
Others include Infants, pregnant, breastfeeding, postpartum
Nutritious Foods & Education
Referrals to other community resources
Breastfeeding Information and Support

4. Internal Improvements
Business/outreach training
Communication skills, outreach plans
Assessing needs of community partners
Will see increase in WIC outreach after February 2016

5. Why Does WIC look different within Indiana?
Managed by a Sponsoring Agency
Agencies are typically a Health Dept., Hospital System, or a Community Action Program
Rules/policies established by agency
Ex: PC and home visits
Still follow USDA & State guidelines
Staffing issued by state based on caseload
More clients in that area then more staff
Clinic in every county
Could have several counties managed by the same sponsor
Clients do not have to see WIC in the county she resides
Do not want clients to clinic hop

6. Limitations Funding designated by USDA
Agency rules differ throughout state
Staff hours/availability based on caseload
One clinic may have many more PC hours if much higher caseload
Similar to hospital staffing: One RN/LC to x # of patients
Can only help the moms that come and get and certified
If we don’t see them, we can’t help them

7. Visits to Clinic Initial certification
F/u 1 month visit if breastfeeding or as needed
Typically 3 months for check pick ups
Mid-Cert
Recertification
After delivery (prenatal to PP)

8. What does a WIC visit look like?
Certification process
Intake with Clerk
Mom provides necessary paperwork
Gives demographic information
Certification with CPA
Gives a brief general health history
Gets nutrition assessment
Lactation assessment as appropriate
Referral to PC
Food package determination
Based on: Prenatal, PP, Breastfeeding, Infant (formula or BF), Child
Educated on how to use vouchers and buy foods at stores
Other referrals as needed
Returns to clinic in 3 months or as needed

9. Breastfeeding Support
Eligible clients receive the following lactation support
Infant feeding classes
Breastfeeding and nutrition education
Peer counselor
Cheerleader, liaison
Private lactation consultation where available
Weight checks, lactation management, etc
Breast pump based on client’s need
Manual, single user, hospital-grade
NICU, back to work/school, increase supply, occasional need

10. WIC & Hospital Collaboration
May look very different throughout the state
Monthly meetings: LC, social worker, etc
Baby Friendly Task Force Meetings
Hospital Certifications
Peer Counselor visits
Weekly referral form pick ups
Nurse Navigator
WIC assisting with a hospital breastfeeding class/support group
We can be creative!

11. Benefits to Collaboration
Improve mPINC score relating to discharge planning
Improve continuity of care from hospital to WIC clinic
Improve exclusivity-JACHO measure
Increase WIC 3 months
Help clients meet lactation goals with lactation services
Referral resource to meet other needs
Healthy families
Nurse Family Partnership
Smoking cessation

12. WIC Hospital Staff Competent Professional Authority (CPA)
RD, RN, or Nutritionist
Would be the person doing certification in hospital
Going through outreach training now
Has attended a 5 day lactation course
Peer Counselor (PC)
Typically a former/current WIC mom
Breastfed a child
Has gone through USDA Loving Support training

13. IU Monroe WIC & Bloomington Hospital Hospital Peer Counselor
Robin Lemieux, RD, IBCLC
Breastfeeding Coordinator
IU Health Bloomington WIC
Heidi Daugherty, RN, IBCLC
Bloomington Hospital
Initial concerns & fears
Benefits & Outcomes

14. Neighborhood Health & Parkview-Hospital Certifications
Breanne Yoder
Nutrition Coordinator
Neighborhood Health Clinics
Angela Russ, MSN, RNC-MNN, IBCLC-pending
Prenatal Supervisor/Birth Planner
Parkview Women’s & Children’s Hospital/Parkview Regional Medical Center
PC in hospital
CPA doing certifications
WIC spent some time teaching Birth Planner about services and process

16. Questions?
Crystal Fowler-