Infant Feeding in the First 30 Days of Life Families Grow Healthy with WIC.

Infant Feeding in the First 30 Days of Life

Families Grow Healthy with WIC


Logistics

Lunch

Restroom

Breaks


Please open your folder

Folder Information


Please pull out the objectives for today and spend a few minutes reviewing.

Throughout today we will revisit these objectives to “chart our route to our final destination”.

Objectives


1. Welcome and Warm Up Activity

2. Review of Objectives & Agenda

3. Review of Healthy Habits Begins at Birth

4. Breastfeeding Support Policy

5. Review of Counseling Skills

6. Morning Break

7. Baby Behavior Skills

8. Baby Nutrition Questions Form

Morning Agenda


9. Lunch and Physical Activity

10. Infant Feeding Choices

11. Afternoon Break

12. Infant Feeding Choices Continued

13. Next Appointment

14. That reMinds me – Idea 2B Used

15. Questions & Answers

16. Trainers’ Gathering

Afternoon Agenda


Think about a positive experience you have had supporting a WIC Mom’s

feeding choice…

Share with a partner

Sharing Successes


Materials & Toolbox


Roadmap to Infant Feeding


Prenatal Education


Keys to Success

From local agencies that have already implemented “no formula in the first 30 days”

Lessons learned

14 years/few months

Many say “it’s not as hard as we thought”

That reMinds Me….


Provide breastfeeding education to prenatal women at each visit.

Include a reminder that no formula will be issued in first 30 days.

Result:

Less mothers are asking for formula after delivery.

Keys to Success


Earn healthy bucks for correct answers.

Healthy Buck = Raffle TicketRaffle at end of the day.

$

Write your name on the back.$

$ Place your healthy bucks in box.

Earn Healthy Bucks


Healthy Habits Begin at Birth

Focused on pregnant, postpartum and breastfeeding women and infant participants

Helped staff become more familiar with food package changes

Promoted and support breastfeeding

Ensured appropriate formula feeding


Work as a table

Write answers on Quiz

When complete – Raise Hand

1st TWO tables to get ALL questions CORRECT will get

Healthy Bucks!

Questions in Envelope

Let’s Play Cash Cab


HHBB Review(Healthy Habits Begin at Birth)

1. Beginning in October, fully breastfed babies on WIC will receive twice the amount of baby fruits and vegetables as other babies from age 6 to 12 months.

Answer: True

64 (4-ounce jars per month) vs.

32 (4-ounce jars per month)


HHBB Review

2. Beginning in October, a mom who is breastfeeding and receiving more than half of the full formula package for her baby can receive a food package until ____ months postpartum.

Answer: 6


3. Beginning in October, an 8 month old baby on WIC who is fully formula fed will receive more formula than WIC currently provides.

Answer: False

Baby will receive LESS formula ------

7 cans powdered formula vs. 9 cans WIC currently provides

HHBB Review


4. To make plenty of breastmilk in the first month, breastfeed often, at least ____ times in 24 hours.

Answer: 8

HHBB Review


5. It’s great for a baby to learn to hold her bottle on her own.

Answer: False

Babies should be HELD for bottle feeding!

HHBB Review


6. After the first week, a baby should have ____ wet diapers a day.

Answer: 6 to 8

HHBB Review


7. Beginning in October, WIC will not routinely provide formula for breastfed babies in the first month because giving formula interferes with breastmilk production.

Answer: True

HHBB Review


Invite prenatal and postpartum mothers to attend a breastfeeding support group.

Result:

Mothers learn about & see other women breastfeeding.

They see that a support system is available for them.

Keys to Success


Move Taxi to

On Roadmap

Breastfeeding Support


How can you support your

Breastfeeding Moms?

Breastfeeding Support Policy

1. Supporting fully and combination breastfeeding moms

2. Conducting complete assessment

3. The second month appointment

Breastfeeding Support


Policy Review

Keep In Mind

This is just one step in supporting breastfeeding.

State WIC is requiring 20 hours of breastfeeding training for all WIC staff (by 2011).

This policy meets the new federal regulations. You can still influence the final rule by sending in your comment to USDA by February, 2010.



Supports breastfeeding mothers and babies by not routinely issuing formula during the first 30 days because formula:

interferes in the development of full milk production, and

decreases the chances that a mother will continue breastfeeding.


WIC is committed to:

Providing timely counseling and education

Scheduling of a second month appointment

Additional incentives based on Institute of Medicine recommendations



Conducting Complete Assessment

The Components:

Dialogue with Mom

Baby Nutrition Questions

ISIS Questions

Counseling Questions



The Second Month Appointment

A follow up breastfeeding assessment and counseling by a lactation specialist

Local agencies established procedures and protocols for the second month appointment based on the Breastfeeding Policy 600XXX



How comfortable do you feel about implementing the policy in your agency?

ON A SCALE OF 1 to 10

Who says 1, 2, or 3?

Who says 4, 5, or 6?

Who says 7, 8, 9, or 10?




Research: More moms are breastfeeding their babies until 1 year of age

How can we best support a combination breastfeeding dyad?


Let’s Define:

Who is a Lactation Specialist?

“not routinely issuing formula”



Who is a lactation specialist?

Any staff who have >20 hours of breastfeeding education and training

CLE, IBCLC, CLC, RDs, PCs

Your agency will designate a lactation specialist based on your definition



“…not routinely issuing formula during the first 30 days”

“not routinely”

not habitually,

not in an expected or customary manner

not generally



Reasons for issuing formula:

USDA interim regulation states, “not routinely issuing formula”

There will be moms who will ask for formula

Anticipating gradual change

Value in data collection



Have your Registered Dietitians see postpartum women for infant enrollment.

Results:

Participants not asking for formula due to prenatal education.

WNAs want to see postpartum mothers.

Keys to Success



Move Taxi Cab to “Tune-Ups”


Breastfeeding Support Policy # 1

Part One:

Supporting Fully and

Combination Breastfeeding Moms

How are we going to support our breastfeeding moms?


Table Toolbox

Toolkit # 1

Counseling Skills


3 Step Counseling Overview

The Dance of Dialog


The 3-Step Strategy

A way to talk with mothers about breastfeeding to help them overcome challenges.

3-Step Strategy:

1. Ask open-ended questions2. Affirm her feelings3. Educate


Step 1: Open-Ended Questions

Open-Ended Questions:

Many answers

Find out what the mother “thinks”

Start a conversation

Start with “What” or “How”

“What do you know about Breastfeeding?”


Avoid Closed-Ended Questions

Closed-ended questions:

“Yes”, “No” or very short answers

Don’t encourage a mother to share her thoughts

Many begin with “do”

“Do you plan to breastfeed?”


Open or Closed Ended?

What does that feel like?

Where do you live?

What time is it?

How do you feel about that?

Is he still in the house?

What’s a good plan for you?

Closed

Open

Closed

Open

Closed

Open


Open-Ended Questions

Review list of open ended questions

Circle questions that might be helpful


Need to Know More?

Don’t understand what the mother is thinking…

There are ways to get more information:

Extending

Clarifying

Reflecting


Getting More Information

Extending questions help you get more information. For example:

Could you tell me a little more about that?

What else can you tell me about breastfeeding?

When you say breastfeeding hurts, could you tell me a little more about that?


Clarifying questions find out what she really means. For example:

When you say that it would be uncomfortable, are you saying it would be uncomfortable for you, or for someone else who might see you?

When you say it hurts, are you saying it hurts the entire time you are breastfeeding?



Reflecting shows her you understand what she said; often we use statements.

For example: So you think your mother doesn’t want you to

breastfeed

So you feel uncomfortable breastfeeding in front of your family

So you feel your baby is still hungry after you feed her



Helpful hints Using mother’s name Repeating her own words Adding extra words

“Why not?”

vs.

“Margie, can you tell me about why you don’t think that’s a good idea?”



Pull out the “Ways of Getting More Information” activity sheet.

In pairs or trios, think of ways you could get more information after a mother says the statement on the sheet.

Write extending or clarifying questions or reflective statements for these statements made by mothers.



Step 2: Affirm Her Feelings

Figure out what a mother is concerned about…

Affirm her feelings

Feelings are normal & okay Shows respect Builds confidence Feels “safe” to open up & listen to ideas


Affirming Statements

“I’ve heard a lot of women say that.” “That’s a pretty common reaction or belief.” “I felt that way too.” “My mother told me the same thing.” “Most women go through a period like that

after the baby is born.” “I can tell you are a concerned mom and

want the best for your baby.”


Activity: Affirm Her Feelings

Pull out the page titled “Affirming Activity”.

In pairs or trios, read the statements & write affirming responses.


Step 3: Educate

Only share information related to her concerns or questions

Give information in small amounts

Have repeated conversations


Explore/Offer/Explore

Explore before giving information:

Ask what she already knows or does Offer information Explore their reaction after giving information

How can you use this information? How might this work for you? What do you think about this?


Activity: Putting it All Together

Read the 2 conversations

In pairs or trios discuss the following:

What did the counselors do well?

How could the counselors improve?


Table Toolbox

Toolkit # 2

Education Materials


THINK to yourself:

Which of these materials do you currently use?

Which ones would you like to use in the future?

Education Materials


Baby Behavior Study

What does my baby need?

Why is he always crying?

Is it normal for her to wake up 4 times a night?

How can I tell if she is hungry?

Why can’t I calm him down?


Study Messages on Cues

Babies can tell moms what they want by using their bodies and noises – cues.

Babies are not always hungry when they cry.

Learning your baby’s cues and how to respond will make you both happy.


Results - Baby Behavior Study

All Sites Combined: More exclusive Breastfeeding Food

Packages selected.

Intervention = 43.6% Control = 16.5%

Less formula given:

3.4% reduction in Formula Feeding 7% reduction in distribution of cans of

formula while caseload increased 3.6%

This project has been funded at least in part with Federal funds from the USDA, Food & Nutrition Service.


Baby Behavior

Misunderstanding their baby’s behavior was the reason many of the mothers we talked to:

Stopped breastfeeding

Gave too much formula and ran out

Gave solid foods too early

Gave unhealthy foods to their babies


Inappropriate feeding may lead to overweight.

Parents want to know more about their baby!

Baby Behavior


Moms believe babies: cry because of hunger, wake because of hunger, and that formula and cereal will prevent this.

They think their babies will stay full longer if they are overfed.

Mothers are pressured by others to feed.

Focus Groups (2003)

Baby Behavior


Parents need tools to

help them believe

they can handle their

infants’ crying and

waking behavior

without overfeeding.

Glanz J Occup Med 1992; 34: 1071-8.

Baby Behavior


Infant “States”

Group of behaviors that occur together:

NCAST Keys to Caregiving

Body movement

BODY

EYES BREATH

Eye movement

Breathing (fast or slow) How much they respond


Crying

Irritable

Quiet Alert

Drowsy

Active Sleep

Quiet Sleep

Increasing intensity

Baby “States”


Crying

Tears

Jerking motions

Responds slowly to comforting measures

Color changes

Tight muscles

Rapid breathing


Common before feeding

Irritable

Lots of body & facial movement

Eyes open but may not want to interact

Sometimes fussy

Sensitive to what’s going on inside & outside their bodies


Requires effort to control!

Quiet Alert

Little body movement

Eyes open and wide

Steady, regular breathing

Highly responsive

Wants to learn and play

Can be tiring for young babies


Easily startled

Drowsy

Variable movement

Irregular breathing

Opens and closes eyes

Eyes glazed

Takes time to react


Active Sleep

Moves every now & then

Breathing pattern changes

Facial twitches

Rapid Eye Movement (REM)

Easy to wake


Hard to wake

Quiet Sleep

No body movement

Rhythmic breathing

Bursts of sucking

Startles but does not wake

Does not respond


Healthy infants will try to control their own state and give cues to “tell” others what they need.

Adapted from: NCAST Keys to Caregiving

Help Baby Control State

Caregivers can play an important role in helping infants feel comfortable and safe.


To awaken use variety Use different positions, touch, words Will take longer if very drowsy or in deep sleep Can take longer for very young infants

Helping Baby Change States

To soothe use repetition Addresses the baby’s needs Repeat actions or words over and over May take time if infant is very upset Change in position or situation might help


Infant Cues

Two types of cues

Engagement

Disengagement


Interactions will have both types of cues, caregivers need to look for pattern.

Kelly et al. Promoting First Relationships, NCAST Pub 2003

Types of Infant Cues

Engagement “Near You” cues:

Young infants try to tell caregivers when they want to interact

Disengagement “Need a break” cues:

Young infants try to tell caregivers when they need to “take a break” or do something different.


Let’s Play WIC Cash Cab



GET READY TO RAISE YOUR HAND!


Disengagement / Crying

What Cue? What State?


Engagement---

Quiet Alert



Disengagement / Quiet Sleep



Disengagement---

Drowsy



Disengagement---

Irritable



Understanding Baby Cues

Key Messages

Babies show their parents what they need with cues.

Babies let you know when they want to be with you or need a break.


Infant Sleep Patterns


Babies wake often in the first few months.

Babies need to dream and wake up to be healthy.Babies wake less often as they get older.

Messages on Infant Sleep


Whole Group:

How many times on average do babies wake up at night (10pm – 6am)?

At 2 mo? _______

At 4 mo? _______

At 6 mo? _______

Your Turn


Average waking at night is:

Peirano et al. J Pediatr 2003; 143: 70-9.

Average Night Waking

Babies wake when sick, uncomfortable, or because of a change of routine.

Too much waking is stressful and should be investigated (before infants are switched from breastfeeding to formula).

2-3 times by 2 months

2 times by 4 months

1 time at 6 months


AS

QS

Wake

Starts in active sleep

Infants sleep 13-14 hrs. per day from 2-12 Mo. (but not all at once!) They spend equal time in active & quiet sleep.

Babies sometimes wake up because moms put them down in Active Sleep.

Newborn Sleep Cycle

Quiet Sleep


At 2-3 months, infants begin with shorter Active Sleep cycles then move into Quiet Sleep

QS

Wake

AS

AS

QS

Sleep Cycle of 2-Month Old

Moms might find it’s easier to put baby down to sleep…


QSFall asleep in Quiet Sleep and sleep more like mom and dad.

QS

AS

ASQS

Much easier to put baby down to sleep…

Sleep Cycle of 4+ Month-Old

Wake


As they mature, infants can link cycles together. (won’t require caregiver with every cycle)

So, infants will sleep longer and will not be as easy to wake as they get older.


Infant Sleep Patterns


Active Sleep (REM) is important for brain development.

Babies dream and blood flows to the brain bringing nutrients to active brain cells

Images stimulate brain function

Quiet sleep is deep sleep, no dreaming or movement, important for the brain to rest.


Infant Sleep State



Waking & Active Sleep

Beneficial for Mother & Baby.

Waking and Active sleep are important for the brain development of the baby.

Waking may be essential to survival—needs must be met for breathing, feeding, warmth.

Breastfeeding mothers’ hormonal cycles are interrupted by night feeds, not having periods may lower risk for hormone related cancers.


Breastfed infants wake more than formula-fed infants and:

Spend more time in Active Sleep

Digest breast milk more quickly

o best for growth & development

Formula-feeding moms can promote Active Sleep by putting babies “back to sleep” and using pacifiers.

Horne et al. Ped Resp Rev 2004; 5: 190-8.

Infant Feeding & Sleep


Key Messages –

Active vs. Quiet Sleep

Why Active Sleep is good for babies

Sleep cycles

How sleep patterns change

Tips for sleepy parents

Healthy Sleep


Baby Marcus is 4 weeks old. His mother tries to put him down after falling asleep at the breast but he:

Wakes up,

Cries loudly

Active or Quiet Sleep?

Was he in active or quiet sleep?


Baby Anna is 4 months old. Her mother tries to put her down after falling asleep at the breast.

She stays asleep!

Active or Quiet Sleep?

Is she in active or quiet sleep?


Crying


Crying makes adults want to help. (Important for survival)

All babies cry

Crying begins in first hours of life, and on average, peaks at 2.6 hours per day at 6 wks.

Crying decreases over the next 10 weeks, much better by 3-4 months.

“Normal” Crying


Watch for these pre-crying signs:

Turning or pushing away

Stretching out of fingers

Tense muscles in his or her face & body

Pre-Crying

“I need a break” Cues


Is there a “Hunger Cry”?

Hungry babies might cry but they will also:

Bring their hands to their face

Clench their hands

Flex their arms and legs

Root

Make sucking motions and noises

All these behaviors together help us know baby is hungry.


Help parents learn to stay calm. Parents can often prevent or

control crying.

Encourage them to get help from friends & family.

Help parents learn their baby’s cues. They won’t stop all crying but

they will feel more in control. Ask them to try your ideas.

Help Parents Deal with Crying


Baby Tanya is 3 weeks old. 10-15 min. after nearly all feedings she becomes:

Fussy, Arches her back, Stiffens her hands & legs.

Why is this Baby Crying?


Baby Luz is 3 weeks old. Every evening between 6 to 8 p.m. she becomes:

Quite Fussy,

Closes her eyes,

Tightens her face,

Cries unless she is constantly held & rocked.



Baby Elena is 4 weeks old. Despite being fed an hour ago, she begins to cry:

Draws her fist toward her chin,

Pulls legs into her body,

Moves her head from side to side.



Key messages

Crying is normal

Babies cry for many reasons, not just because they are hungry

Babies show other cues when they are hungry

Why do Babies Cry?


For pregnant women at For pregnant women at the end of their the end of their

pregnancypregnancy

Getting to Know Your Baby

Contains facts and tips Contains facts and tips to help new moms cope to help new moms cope during the first 6 weeks during the first 6 weeks postpartumpostpartum


That’s All Folks


Let’s Play Simon Says!

“Simon Says”

Stand up and walk around your table clockwise one time and sit back down


Breastfeeding Support Policy #2

Conducting Complete AssessmentDIALOGUE

WITH MOMS

ISIS

QUESTIONS

COUNSELING

QUESTIONS

BABY NUTRITION

QUESTIONS


Moms & Babies

Gloria and Gustavo


Moms & Babies

Susie and Sammie


Moms & Babies

Wilma and Wil


Moms & Babies

Cyndie and Carrie


Assessment


BABY NUTRITION

QUESTIONS

DIALOGUE

WITH MOMS

ISIS

QUESTIONS

COUNSELING

QUESTIONS



Questions to ask about Gustavo


In pairs discuss what other questions you would ask about Sammie and Carrie



Sammie and Carrie

In pairs or trios, review scenarios What are the feeding issues for both

scenarios? What are some additional open-ended

questions you would ask each of these mothers?


Answers For You


Lunch Time!

Be back on time!

Simon Says . . .


Welcome Back!

Freeze!

Simon Says . . .


New Breastfeeding Support Policy

Support Fully and Combination Breastfeeding

mothers

Reviewed Counseling and Baby Behavior skills

Started on Components on Complete Assessment


Dialogue with Moms = Driving Down that Route Soon

Review of Morning


Open or Closed?

Is this question open or closed-ended?

“Is your baby sleeping well?”


Is this question open or closed-ended?

You are planning to breastfeed, right?

Open or Closed?


Question

What are the minimum number of hours of training a lactation specialist needs to have?


True or False

True or False: A one month old baby falls asleep in quiet sleep.


Question

Is this infant engaged or disengaged?


Infant Feeding Crossroads

Fully Breastfeeding?Formula Feeding?

Combination Feeding?


Breastfeeding Expressway



Fully Breastfeeding

With your partner discuss:

What will be different for fully breastfeeding moms and babies?

How will you discuss your breastfeeding services with mothers?


What will be different?

Moms and babies will receive the largest amount and most variety of foods.

At 6 months babies will receive baby fruits, vegetables and meats.

Fully breastfed babies receive MORE baby food than other babies.

Babies will no longer receive juice.

Fully Breastfeeding


What resources might be available?

Lactation specialists (IBCLC, CLE, CLC, Peer Counselor)

Breast Pumps

Education Materials and Classes

Community Resources

o La Leche League, Public Health Nurses

Fully Breastfeeding


Key to Success

Designate a “Lactation Specialist” for the day to…

Provide pregnant and breastfeeding women with needed support and help

Be accessible to staff for any breastfeeding help and questions

Result:

Staff feel more confident.

Breastfeeding mother’s needs are met!


“Your WIC Foods”

Overview of new food packages

What do you see that is new?

What differences do you notice between the packages?

How will you use this tool to encourage as much breastfeeding as possible?


Formula Feeding


What will be different for

Formula feeding moms and babies?

How will you discuss formula feeding with moms?


What will be different? Babies will receive less formula. The amount of formula will change according to

baby’s age. Babies will receive baby food starting at 6

months. Babies won’t receive as much baby foods as

breastfed babies. Babies will no longer receive juice.

Formula Feeding


What will you discuss?

Always holding baby while feeding

Proper preparation of formula

Formula Feeding


Cash Cab

How do you plan to support

your fully breastfeeding Moms

starting Oct 1?


Cash Cab

How do you plan to support

your fully formula feeding Moms

starting Oct 1?


Combination Feeding



What will be different for…

Combination feeding moms and babies?

How will you discuss combination feeding using “Your WIC Foods” to support breastfeeding?

Combination Feeding


What will be different? 2 Categories – mostly and some.

Babies will receive less formula.

The amount of formula will change according to baby’s age.

Babies will receive baby food starting at 6 months.

Babies won’t receive as much baby foods as fully breastfed babies.

Babies will no longer receive juice.

Combination Feeding


What are some of the reasons breastfeeding moms ask for formula?

I’m going back to work or school.

I want formula just in case…

I don’t have enough milk.

My family members want to feed my baby too.

I (or my baby) have a health issue and can’t fully breastfeed.

Combination Feeding


Assessment


BABY NUTRITION

QUESTIONS

DIALOGUE

WITH MOMS

ISIS

QUESTIONS

COUNSELING

QUESTIONS


Let’s watch our WIC actors as they model a challenging breastfeeding scenario.

Find your “Observer’s Checklist”

Combination Feeding


Work in trios – (Roles)

1. Counselor 2. WIC mom3. Observer

Role play the “Gloria/Gustavo” scenario.

How will you counsel the mom?

What tools would you use?

Combination Feeding


What went well?

What were some issues?

What tools did you use?

Combination Feeding


Switch roles

Now role play “Sammie” scenario.

How will you counsel the mom? What tools would you use?

Combination Feeding


What went well?

What were some issues?

What tools did you use?

Combination Feeding


Key to Success

At anytime when a fully or combination breastfeeding mom asks for formula, have a lactation specialist see her to assess her breastfeeding.

Result:

Increase in breastfeeding duration

Decrease in formula issuance


Table Toolbox

Toolkit # 3

Resources


WIC Reference Tools

Guidelines for Referrals

Formula Table

Breastfeeding Resource List

Report: “Amount of formula issued by your agency”


Guidelines for Referrals

Health & Nutritional Condition

May need referral to support mother

May affect infant’s growth pattern

May still fully breastfeed


Guidelines for Referral

Breastfeeding Infant is:

Twins

Jaundice

Constipated

Yes

No

Yes


Formula Table

Minimum amount of formula needed


Breastfeeding Resource List Online

California Breastfeeding Coalition

La Leche League

United States Breastfeeding Committee

Office of Women’s Health

Resources


Data Collection

Report: Amount Formula Issued by your agency

Recognize your employees who excel in breastfeeding promotion

Identify the training needs

Monitor your exclusive breastfeeding rates

(fully, mostly, and some bf)


BREAK


Honk if you love Breastfeeding

Come up with a bumper sticker slogan to support fully breastfeeding in the first 30 days.

Use only 15 words or less

Write on flipchart paper w/markers


What Would You Do?

In pairs or trios discuss how you would counsel Carrie’s mother.

What are the feeding issues?

What questions would you ask?

What actions would you take?


Activity Time

What are the feeding issues?

What questions would you ask?

What actions would you take?


What Would You Do?

Questions to ask Tell me about a typical feeding. Let’s talk more about her diapers. Tell me more about how your baby sleeps.

Things to do Refer to Lactation Specialist or send to the

Emergency Department Weigh the baby Issue Combination Package Schedule appointment for next month


Enroll and Recertify


Assessment


BABY NUTRITION

QUESTIONS

DIALOGUE

WITH MOMS

ISIS

QUESTIONS

COUNSELING

QUESTIONS


ISIS Documentation

Must enter:

Reason for formula issuance

Input into the child INEP ISIS Screen


ISIS defaults to “fully breastfeeding” package when “combination feeding” is entered.

You will have to change to “C”

ISIS will automatically issue just one month of Food Instruments.

Issue Food Instruments


Fully Breastfeeding Package (BE7)

BE7 for fully BF mom; BM8 for Fully Multiples

IB1 = 0-5 mo. fully breastfed, no check for infants

IB2 = 6-11 mo, fully breastfed, infant foods



Mostly Breastfeeding Package

Infant codes: IC1, ICQ, and IC2

Mom certified for 1 year

Mom receives more variety of foods

Codes: BC5 -X,L,S,T,H,P,G



Some Breastfeeding Package (BO6)

Infant codes: IO1, IOQ, IO2, and IO3

Mom receives checks up to 6 months

Mom may choose to attend breastfeeding support up to 1 year.

Mom codes: BO6 and B06N



Combination Feeding

Must be in second month

Must be with a lactation specialist

Fully Breastfeeding

Based on needs of mom and baby

Schedule Next Appointment


Assessment

Completed Assessment

BABY NUTRITION

QUESTIONS

DIALOGUE

WITH MOMS

ISIS

QUESTIONS

COUNSELING

QUESTIONS


The Second Month Appointment

Fully breastfeeding mothers may see lactation specialist if needed.

All combination feeding mothers see a lactation specialist who will:

Conduct complete assessment

Determine the need for continued formula

Provide appropriate breastfeeding support and counseling


Your Souvenir

Complete Assessment Checklist for supporting your breastfeeding moms


1. Supporting Fully and Combination breastfeeding moms

2. Components of Complete Assessment

3. The Second Month Appointment



Today you heard 5 Keys for Success from agencies who have already implemented the new 30 day policy.

Take the keys out of the toolbox Pass the keys clockwise until you hear

“STOP!” Share how you might apply the “key” at

your agency Use your “That reMinds Me” form

Review Keys to Success


Answers for You


End of the Ride


wic


WIC – Healthy and Happy

Wil

Sammie

GustavoCarrie


Final Destination

Evaluation

Infant Feeding in the First 30 Days of Life Families Grow Healthy with WIC.

Documents

Transcript of Infant Feeding in the First 30 Days of Life Families Grow Healthy with WIC.