The Breastfeeding Education Special Interest Group (BFE SIG) was approved by the NAPNAP Executive Board in spring 2002. Since its inception, the SIG has been very active in clinical and advocacy issues related to breastfeeding, nutrition and other infant/mother health care issues.
- Academy of Breastfeeding Medicine (for clinical protocols)
- The CDC Guide To Breastfeeding Interventions
- International Lactation Consultant Association (ILCA)
- Edinburgh Post-Natal Depression Scale
- US HHS Women’s Health
- Kellymom: great resource for mom
- Billing for Lactation Services – AAP Guide (provides guidance on billing codes and requirements)
Do you know about the life-saving work being done by the members of the Human Milk Banking Association of North America? HMBANA is a multidisciplinary group of health care providers that promotes, protects and supports milk banking. It is the professional membership organization for milk banks in the United States, Canada and Mexico, setting the standards and guidelines for donor milk banking that supplies preemies and other medically fragile newborns with pasteurized, screened, medically-prescribed donor breast milk. For many babies, this milk means the difference between life and death, because their tiny, underdeveloped bodies are not able to process formula and because (for a variety of reason) their own mothers may not be able to breastfeed. Learn more about HMBANA, the 11 milk banks across the U.S. and the organization’s April conference celebrating 100 years of milk banking at hmbana.org.
For more information, contact HMBANA at 408-998-4550. Additional information can be provided from the United States Breastfeeding Committee at 202-367-1132, ILCA/USLCA at 1-800-452-2478, or La Leche League at 847-519-7730.
As breastfeeding advocates, it is good for us to know what the laws in our state are. Please review the laws in your state and do what you can to advocate for needed changes.
The Tri-Core Breastfeeding Model is a best practice guideline and framework aimed at increasing breastfeeding rates, enhancing promotion and improving the health outcomes of women and children.
Read more about the Tri-Core breastfeeding conceptual model in the Journal of Pediatric Health Care.
The Tri-Core model emphasizes:
A. Maternal Self-Efficacy
B. Maternal and Professional Lactation Support
C. Maternal and Professional Lactation Education
Resources for PNPs: The Tri-Core Breastfeeding Model is an initiative of a task force for the NAPNAP Breastfeeding Education (BFE) Special Interest Group and the subject of the DNP project of BFE member Deborah Busch, DNP, CPNP-PC, CLC.
A. Maternal Self-Efficacy — Breastfeeding self-efficacy is a mother’s perceived confidence in her ability to successfully breastfeed and to manage problems when they arise. Integrating key strategies will increase a mother’s confidence in her ability to breastfeed successfully.
Key self-efficacy strategies
- Provide or refer mothers to mother-to-mother support groups, peer counseling and local breastfeeding coalitions for breastfeeding support and information.
- Develop and appropriately communicate an individualized breastfeeding care plan that is maternal-driven and maternal goal-oriented.
- Inform the family of local breast-pump supplies and insurance coverage for lactation services, counseling and equipment. Educate the mother on her State and Federal Rates to pump while at employment or school.
- Involve partners and family in breastfeeding decisions and encourage family members to attend infant well-child visits.
- Listen with empathy, giving information focused on mother’s unique needs and provide encouragement and empathy for her breastfeeding efforts. Provide a self-efficacy questionnaire survey and/or post-partum depression screen tools.
- Provide evidence-based information about positioning, latch, frequency and length of feedings. Avoid offering conflicting or outdated advice.
- Identify mothers at risk for breastfeeding problems and early cessation of breastfeeding by assessing medical, cultural, social, psychological, physical and environment barriers that may affect breastfeeding outcomes.
- Identify infant health conditions that may affect breastfeeding duration and refer if necessary.
B. Lactation Support — Professional Lactation support consists of counseling and management interventions that are current, evidence-based practices to improve duration and exclusivity rates among families.
Key lactation support strategies
- Facilitate early initiation of breastfeeding (within one hour of the infant’s birth if stable); standardize mother to mother rooming-in and frequent cue-based feedings.
- Demonstrate and assist with latching and positioning including but not limited to laid back breastfeeding, the football hold, the cross-cradle hold and cradle positioning.
- Restrict use of formula supplements unless medically indicated. Recommend the use of expressed breast milk or human banked milk as the preferred choice rather than infant formula.
- Perform an assessment of the mother-baby dyad, with emphasis on the latch, oral anomalies, adequate milk transfer, infant weight, hydration, jaundice, feeding activity, output and lactogenesis.
- Provide basic evidence-based breastfeeding management and interventions.
- Collaborate with and/or refer the mother to a lactation consultant/educator or other health care professionals trained for complex breastfeeding problems as needed.
- Provide follow-up phone calls and lactation visits for breastfeeding support (adjunct staff can also provide) until parents feel confident and the infant has a consistent appropriate weight gain in the early newborn period.
- Advocate preservation of breastfeeding under adverse conditions, emergencies and/or during illnesses of either the mother or baby whenever possible.
- Create an office ‘‘Breastfeeding Policy Statement’’ recognizing, valuing, and safeguarding the benefits of breastfeeding for patients, families, and the health care staff.
C. Lactation Education — Lactation education involves providing breastfeeding educational materials and resources to families. Lactation education also involves educating providers and staff regarding current EBP lactation practices and strategies.
Key lactation education strategies
- Educate families and colleagues about the importance of exclusive breastfeeding and the risks of formula feeding in the early newborn period. Have printable and online resources readily available to distribute.
- Encourage exclusive breastfeeding for the first 6 months of life, continued breastfeeding with the addition of appropriate complementary solids up to the age of one and beyond as mutually desired by the mother and the child.
- Educate families and colleagues about breastfeeding basics, infant patterns, maternal diet and how to determine that the infant is getting enough milk. Educate about he scientifically proven short and long-term benefits of breastfeeding for the infant, mother and society.
- Use culturally appropriate materials to educate the mother and family members involved in the infant’s care regarding the benefits and management of breastfeeding.
- Have resources and materials ready to address common breastfeeding issues, such as low/high milk supply, engorgement, maternal diet, latch, slow-growth, jaundice, growth patterns/spurts, pumping, nipple or breast pain, medications, school and employment struggles.
- Refer to IBCLC when advanced maternal or infant issues occur. Maternal issues may include milk supply, problems with letdown, polycystic ovarian syndrome, diabetes, obesity, hypoplasia, post-partum depression and medication usage. Infant issues may include colic, severe jaundice, possible food-related allergies, hypoglycemia, prematurity, multiples, tongue-tie, breastfeeding-related colitis and slow to gain weight/FTT.