Category Archives: maternal and child health

Story From the Field: Children’s Home Society of Florida

By Shannon Currie, MSL, Community School Director, Children’s Home Society of Florida and Harumi Reis-Reilly, MS, LDN, IBCLC, Lead Program Analyst, Breastfeeding Project, Safe, Healthy and Resilient Communities, NACCHO

Meeting Teen Moms Where They Are: An Innovative School-based Breastfeeding Program

Children’s Home Society and Commonsense Childbirth engaged the community of Pine Hills from community-based partnerships designed to demonstrate improvement in breastfeeding practices for registered participants in the early post-partum period, at 6 months and 12 months, as compared to 2013 statistical data collected from the Florida Department of Health. Children’s Home Society (CHS) of Florida provided Wellness Coaches to deliver peer lactation support and education through direct referral and online support through the Peer and Online Lactation Support (POLS) portal.

Adolescent African American mothers face unique challenges to breastfeeding at optimal rates in the rural, low-income area of Pine Hills, Florida. Through funds from NACCHO’s Reducing Disparities in Breastfeeding through Peer and Professional Support grant, Children’s Home Society of Florida implemented a breastfeeding support program in a local high school, bringing much-needed support services to new and expecting teen mothers.

Challenge

Pine Hills, one of the poorest areas in Florida, is a predominately African American community, with significant racial disparities in birth outcomes, Sudden Infant Death Syndrome (SIDS) rates, and breastfeeding initiation rates. Pine Hills is located within Orange County. In 2016, the overall infant mortality rate for Orange County was 7.1 per 1,000 live births, while the black infant mortality rate was 12.3 per 1,000 live births. These both represent an increase over infant mortality in 2015.1 In 2015, the Orange County birth rate among adolescent mothers aged 15-19 was 15.1 per 1,000 for white teens and 29.6 per 1,000 among black teens, higher than the Florida state adolescent birth rate of 20.3 per 1,000.2 In addition, Pine Hills’ overall unemployment rate is 14%.3

The lack of a supportive environments in the Pine Hills community makes breastfeeding an unfeasible option for families, especially for adolescent African American mothers. There are no Baby-Friendly Hospitals (BHFI) serving Pine Hills residents, and their community lacks formal workplace breastfeeding support policies and breastfeeding-friendly Early Care Education facilities. Within the community, there is only one part-time, professional lactation support provider located in the local WIC office. Transportation is usually an additional barrier to accessing services in rural areas. This barrier is heightened for adolescent mothers, as they often must rely on parents or guardians for transportation. Additionally, teens may not be empowered to make their own health decisions. Therefore, if their families do not support breastfeeding, they may not be able to access support services at all.

Children’s Home Society (CHS) of Florida is the oldest and largest statewide organization in Florida serving children and families. During their 112-year history, CHS has worked with pregnant and post-partum women to provide home visiting services including Healthy Start, Healthy Families America, and Early Head Start. With funding from NACCHO, CHS focused on engaging Pine Hills’ adolescent mothers in breastfeeding support services.

Working with minors brings unique challenges. Many lack transportation, have competing time demands of school and work, and experience the social stigma around teen pregnancy, which often results in a lack of social support. Prior to working with CHS, Evans High School (EHS) had no existing breastfeeding support for student mothers to breastfeed at school. Teen mothers and their families did not have the education and support needed to challenge common breastfeeding myths and overcome barriers.

Solution

CHS developed a breastfeeding support program at EHS to provide educational, emotional, and social support to pregnant and new teenage mothers. Teens today are digital natives and new mothers tend to spend more time online after giving birth. CHS made use of technology to engage expecting and new adolescent mothers in breastfeeding support services through their Peer Online Lactation Support (POLS) program, which provides mothers with interactive online lactation support and educational resources.

Establishing relationships with key partners including school administration, staff and students, Orange County Public Schools (OCPS), and True Health Wellness cottage was essential to the program’s success.  Cultivating relationships with community partners including WIC, Healthy Start Coalition of Orange County, and Common Sense Childbirth (CSC) helped to identify resources for mothers beyond the school setting.

In collaboration with CSC, CHS increased their organizational capacity by training culturally diverse community health workers, also known as Wellness Coaches, using the Community Outreach Perinatal Education (COPE) curriculum. This enabled the Wellness Coaches to become doulas, childbirth educators, and lactation educators. Those newly trained coaches were then matched with pregnant clients to provide breastfeeding support throughout the pregnancy and postpartum period.

Results

CHS used their partnership with OCPS and EHS to open a “No-Judgment Zone” lactation room, equipped with a hospital-grade lactation pump, within the high school building for the student mothers to pump and store breast milk privately during the school day. Participating students were issued special hall passes from school administrators who acted as student advocates to ensure that pumping breaks did not affect class attendance. Additionally, a new lunch program was introduced for pregnant and breastfeeding students to receive additional healthy foods to meet the increased nutritional needs of breastfeeding mothers.

Wellness Coaches engaged teen mothers’ families to improve support at home. Students were encouraged to invite their support system, including grandmothers and fathers, to ongoing group meetings. Wellness Coaches used these opportunities to dispel breastfeeding myths and provide educational support to every person directly involved with the mother’s parenting and breastfeeding process.

CHS addressed the transportation barrier for teens co-locating lactation support services within the school grounds meeting the teens where they were. Additionally, providing support through their online portal, http://www.ifeedmybaby.com, allowed teen mothers and fathers to ask questions and engage with Certified Perinatal Educators at any time.

Lessons Learned

CHS encountered some challenges when implementing its program. Establishing key partnerships enabled them to succeed and sustain the program. Partnering with OCPS and EHS and training breastfeeding champions within the high school allowed CHS to create a more accepting breastfeeding environment within the school setting. In addition to the school partnership, CHS worked in collaboration with the Easy Access Women’s Health Clinic to integrate CHS perinatal educators, who then provided education and resources to expecting mothers in the clinic. An additional partnership was established with the pregnancy center to provide monthly breastfeeding support groups with new and expecting mothers. CHS can also attribute their success to engaging the teens’ families, who often are the decision-makers in their children’s lives.

CHS has improved the breastfeeding landscape in Pine Hills by changing systems and strengthening partnerships to create a more breastfeeding-friendly environment. CHS support services have become a signature initiative that is well attended by pregnant and post-partum teen mothers and fathers. Currently, CHS has extended their breastfeeding services to two additional community providers who serve teen and adult mothers. They have also expanded the program to another high school within a predominately black and largely underserved community.

For more information:

Children Home Society of Florida: https://www.chsfl.org/

References

  1. Florida Department of Health. (2017). National Infant Mortality Awareness Month. Retrieved from http://orange.floridahealth.gov/newsroom/2017/09/infant-mortality.html Accessed on October 17, 2017.
  2. Florida Department of Health, Bureau of Vital Statistics. (2015). Birth by Mothers Age – Orange County. Retrieved from http://www.flhealthcharts.com/charts/
  3. U.S. Census Bureau; American Community Survey, 2011- 2015 American Community Survey 5-Year Estimates, (2015 – Employment Status, Pine Hills CDP, Florida; using American FactFinder; http://factfinder2.census.gov

Laying the Infrastructure for Breastfeeding Partnerships in Lee County

By Emily Bernard, IBCLC, NACCHO consultant in collaboration with Carol Lawrence, PhD, MS, BSN, RNC-OB and Lori Riddle, Lori H. Riddle, RD, LD/N, CLC  Florida DOH and Lee Health

Synopsis

The Florida Department of Health in Lee County (DOH Lee) worked alongside three hospitals during NACCHO’s Reducing Breastfeeding Disparities through Peer and Professional Support project. DOH Lee’s project was designed to improve the county’s environment to support breastfeeding for black families through the establishment of a strategically developed coalition, as well as through the provision of advanced training of agency and hospital staff, other than nurses, to improve breastfeeding support within the hospital and the community. DOH Lee helped to implement the EMPower Breastfeeding Project by providing prenatal education and postpartum support to low-income, black families delivering in these enrolled hospitals. Continue reading

Shifting Internal Policies and Systems to Create Breastfeeding Continuity of Care

By Carmen Vergara, RN, MPH (ESPERANZA HEALTH CENTERS) and Harumi Reis-Reilly, MS, CNS, CHES, IBCLC (NACCHO)  

Esperanza Health Centers, a former grantee of NACCHO’s Breastfeeding Initiative, is a Federally Qualified Health Center (FQHC) on the Southwest side of Chicago. The main population served is predominately low-income and Latino, and families in Esperanza’s service area experience significant economic, educational, and health inequities. Over 70% of area residents live 200% below the poverty level. Esperanza’s main services are adult primary care, pediatrics, prenatal care, and behavioral health. Additional public health services include programs related to children’s weight management, diabetes management, and physical activity. Continue reading

Removing Barriers to Breastfeeding in Niagara County

istock_000000346530_mediumBy Elaine Roman, MA, BSN, RN, IBCLC, ANLC Director, Division of Public Health Planning and Emergency Preparedness, Public Information Officer & Elise Pignatora, MS, CLC Public Health Resource & SNS Support Officer, Niagara County Department of Health

For the past three years, Niagara County (NY) Medical Reserve Corps (MRC) has received the MRC Challenge Award from the National Association of County and City Health Officials (NACCHO) for their breastfeeding initiative, “Energizing Partnerships to Advance Support Networks for Breastfeeding Mothers.” Director of the Division of Public Health Planning in the Niagara County Department of Health Elaine Roman, MA, BSN, RN, IBCLC, ANLC and Public Health Resource and SNS Support Officer Elise Pignatora, MS, CLC led the lactation initiative. The Niagara County Department of Health’s inspiration for this intervention to the 215,000 population community came from the 2011 Surgeon General’s Call to Action to Support Breastfeeding.  “We also looked at the Healthy People 2020 numbers and realized our county was not performing the way we would like it to be in regards to initiation, duration, and exclusivity of breastfeeding in our county,” Roman said. Continue reading

Using Triple P as a Model to Engage Communities and Prevent Child Maltreatment

By Calondra Tibbs, MPH, Senior Director, Safe and Healthy Families, NACCHO

Positive relationships between caregivers and children play an important role in the health and well-being of children throughout their lives. Establishing safe, stable, and nurturing environments and relationships and limiting exposure to adverse experiences (e.g., trauma, abuse, and neglect) can potentially reduce poor health outcomes and behaviors in a child’s adolescent and adult lives.1 The Adverse Childhood Experience (ACE) Study demonstrated that increased exposure to maltreatment can increase risk for alcoholism and alcohol abuse, illicit drug use, liver disease, smoking, unintended pregnancies, and chronic obstructive pulmonary disease.1 Continue reading

National Breastfeeding Month: Reducing Disparities through Peer and Professional Support

By NACCHO’s Safe & Healthy Families Team

August is National Breastfeeding Month, a time to focus on promoting and protecting breastfeeding in the United States. Public health workers hope to use the month-long spotlight to generate awareness about the importance of breastfeeding, help ensure access to necessary lactation care and services for all women, including those in the workforce, and support all present and future breastfeeding mothers.

Breastfeeding is one of the most effective ways mothers can prevent disease and protect the health of their infants. Continue reading