Breastfeeding Support During COVID-19 · Breastfeeding Initiation by Mother’s Race & Ethnicity...
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Breastfeeding Support During COVID-19: The Powerful Role of the Community Health Worker Treva Smith, Kansas Breastfeeding Coalition Board of Directors & Community Health Worker, KC Care Health Clinic Diana Lady, Health Promoter, Kansas Farmworkers Program
Transcript of Breastfeeding Support During COVID-19 · Breastfeeding Initiation by Mother’s Race & Ethnicity...
Breastfeeding Support During COVID-19: The Powerful Role of the Community Health
Worker
Treva Smith, Kansas Breastfeeding Coalition Board of Directors & Community Health Worker, KC Care Health Clinic
Diana Lady, Health Promoter, Kansas Farmworkers Program
"[...] exclusive breastfeeding goes a long waytoward canceling out the health differencebetween being born into poverty and being borninto affluence...It is almost as if breastfeedingtakes the infant out of poverty for those firstfew months in order to give the child a fairerstart in life [...]“- James P. Grant, former UNICEF executive director
Breastfeeding Matters
Breastfeeding reduces:• Mother’s risk of breast and ovarian cancer• Improves mother and infant’s mental health• Infant’s risk of SIDS by up to 50%• Health care costs – save $27 Million per year in Kansas
How Does Kansas Compare?
83.8
47.5
25.4
36.2
88
57.3
31.434.6
81.9
46.2
25.5
34.1
0
10
20
30
40
50
60
70
80
90
100
% Initiation % Exclusive @ 3mos.
% Exclusive @ 6mos.
% Any Bfing @ 12mos.
U.S
.
Kans
as
HP
2020
Goa
l
Data Source: National Immunization Survey, 2016 births
72.977.4
84.4 83.8
77.1
83.688
30.5
37.4
48.4 50.2
44.5
50.4
57.3
15.111.4
24.5 23.4 24.5 26.1
31.4
0
10
20
30
40
50
60
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100
2010 2011 2012 2013 2014 2015 2016
%KANSAS BREASTFEEDING RATES OVER TIME
Initiation Excl. at 3 Mos. Excl. at 6 Mos.
Data Source: National Immunization Survey, 2016 births
11th in the Nation!!
Indicators of Breastfeeding Support
26.1
17.2
41.1
13.5
0
5
10
15
20
25
30
35
40
45
% live births at Baby Friendly Facilities % supplementation in day 1-2
National
Kansas
Data from CDC 2018 Breastfeeding Report Card
Where you live matters
Race & Ethnicity Matters
94.1
89.587.5
81.679.2
70.0
75.0
80.0
85.0
90.0
95.0
100.0
Asian NH White NH Hispanic Native American,NH
Black NH
Perc
ent
Breastfeeding Initiation by Mother’s Race & EthnicityKansas 2016-2018
Note: NH = non-HispanicSource: Birth Certificate Data, 2016-2018, Bureau of Epidemiology and Public Health Informatics, Kansas Department of Health and Environment
Kansas 88.4%
It would -• Prevent 22 maternal deaths• Prevent 7 infant deaths• Save of $26 Million in medical costs
If 90% of babies in Kansas were breastfed according to medical recommendations…
Breastfeeding Saves Lives Calculator, www.usbreastfeeding.org/saving-calc, Access October 26, 2018.Stuebe, A. M. et al (in press - 2017). An online Calculator to estimate the impact of changes in breastfeeding rates on population health and costs. Breastfeeding Medicine
Economics, Infant & Maternal Mortality Matters
What is a Community Health Worker?
A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities such as outreach, community education, informal counseling, social support and advocacy.
COVID-19 & Breastfeeding
The virus has not been detected in breast milk to date.
CDC Guidance
https://www.cdc.gov/coronavirus/2019-ncov/hcp/care-for-breastfeeding-women.html?eType=EmailBlastContent&eId=e2347c70-8e0a-47ab-abf1-7f81f879a5c4Accessed May 14, 2020
A mother with suspected, probable, or confirmed COVID-19 should:
• Wash her hands using soap and water before touching the infant or breast pump. If soap and water are not available, she should use a hand sanitizer with at least 60% alcohol.
• Wear a cloth face covering while feeding at the breast or when pumping.
Currently, there is a lack of evidence to support precautions such as cleansing the breast prior to breastfeeding or milk expression, or disinfecting external surfaces of milk collection devices (e.g., bottles, milk bags), as steps to reduce potential transmission of SARS-CoV-2.
In the hospital, the determination of whether or not to separate a mother with known or suspected COVID-19 and her infant should be made on a case-by-case basis using shared decision-making between the mother and the clinical team.
All caregivers should wash hands and wear a cloth face covering while feeding a baby
COVID-19: KBC Response & Support
In-person classes rescheduled to AugustProviding GoToMeeting support to local
breastfeeding coalitions for virtual meetingsMaintaining COVID-19 resource page:
http://ksbreastfeeding.org/resources/information-and-resources-for-covid-19-and-breastfeeding/
Changes in Support During COVID-19
More• Virtual/online support• Stress• Confusion• Uncertainty• Isolation
Less• In-person support
(groups, WIC, physicians, etc.)
• Visitors• Extended family visits• Prenatal visits
Role of Community Health Worker in Breastfeeding Support
Cheerleader – recognize signs of “normal” breastfeeding and cheering the mother on
Lifeguard – recognizing when a mom & baby are in over their heads and require assistance from a lactation support provider
EXAMPLE:KANSAS FARMWORKER PROGRAM
KSFHP Service Areas Voucher/Case Management Infrastructure
18KSFHP currently has 114 Access Point Agencies in 85 Counties
MISSION - To Protect and Improve the Health and Environment of all Kansans
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Identification of Barriers
2014 Health Status Survey & Annual Focus Groups:• High Cost (includes no insurance)• Language translation and interpretation• Literacy levels• Transportation and isolation• Lack of history of preventive services• Mobility of clients and distance to clinic • Difficulty leaving work to get services• Clinic not open when available for appointment
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MISSION - To Protect and Improve the Health and Environment of all Kansans
Prenatal CareLanguage
Education
Level
Transportation
Health Care
Access
Referral to LegalOffices
KSFHPVoucher
Economic Security
Legal Issues
Food Security
KSFHP
Health Promotion
Rides
Food PantryWIC
Interpreting
Identification of Barriers
Health Education
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http://www.kdheks.gov/olrh/download/Summary_Healthy_Plate_Healthy_Weight.pdf
MISSION - To Protect and Improve the Health and Environment of all Kansans
Health Education Topics
• Diabetes Quality of Care Initiative• Family Planning/Prenatal Care• Behavioral Health• Oral Health• Obesity• Tobacco Cessation• Breastfeeding• Safe Sleep for Babies/Sleep sack• KSFHP Calendars•
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MISSION - To Protect and Improve the Health and Environment of all Kansans
Example: Kansas Farmworker Program
Health promoters:
• Promote breastfeeding because breastfeeding questions are integrated into new home visit
• Recognize the tools they have available for clients
• Use the breastfeeding resources with clients & refer when necessary
Long term positive outcomes from CHWs promoting and supporting breastfeeding
RESOURCES – BUILDING YOUR “TOOL BOX”
Find Your Community’s “Lifeguards”
Lactation Credentials:Who are the breastfeeding experts in your
community?
Title Training
IBCLC – International Board Certified Lactation Consultant
2-3 years, 90 hours of education,college courses, 1000 clinical hours, pass exam
CLC – Certified Lactation Counselor 5-day course = 45 hours of education, pass exam
CLE/CBE – Certified Lactation/Breastfeeding Educator
3-day course + additional work
Breastfeeding Peer Counselor (WIC, La Leche League, etc…)
~ 1 yr. training, personal breastfeeding experience
Resources for Parents
Prenatal Education Classes
• Ready, Set, Baby - This interactive, online resource allows expectant parents to plan for successful breastfeeding through a self-paced experience.
• Global Health Media,– instructional breastfeeding videos from latching and hand expression to nipple pain and engorgement, available in several languages.
• The Institute for the Advancement of Breastfeeding and Lactation Education (IABLE) – instructional videos showing paced bottle feeding, finger feeding and cup feeding are publicly available in English.
Found HERE -http://ksbreastfeeding.org/cause/prenatal-breastfeeding-class-for-parents/
Connect with Local Breastfeeding Coalitions
Directory HERE -http://ksbreastfeeding.org/coalitions/
Learn About Breastfeeding
• 2020 Breastfeeding Conference, Oct. 29-30 in Wichita http://ksbreastfeeding.org/events/2019-breastfeeding-conference/
• Online breastfeeding courses, webinars & trainings-http://ksbreastfeeding.org/resources/education-healthcare-professionals/
http://ksbreastfeeding.org/our-work/breastfeeding-education-courses/Kansas City, Jan. 3 – Breastfeeding Basics
CEU’s for nurses, dietitians and lactation consultants
It’s like riding a bike!!
https://dhpraxis14.commons.gc.cuny.edu/2014/12/05/aha-i-finally-got-it/
http://wamu.org/news/14/10/27/are_the_roads_becoming_more_dangerous_for_bike_riders
Key Take-Aways: Your Homework
1. Ask families “What have your heard about breastfeeding?”2. Educate yourself and/or staff about breastfeeding basics3. Ask local WIC agency for breastfeeding materials for parents4. Find you local “lifeguards” and know how to refer to them
