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Peer Counseling: Making a Difference for WIC Families
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Breastfeeding: A WIC Priority
• Improves health outcomes for infants– Fewer infections and disease– Improved IQ– Lower rates of obesity and diabetes
• Improves health outcomes for mothers– Faster recovery from pregnancy– Lower risk of breast cancer
• Reduces health care costs
Risks of Not Breastfeeding
100
178
257
6732
6423 18
56
138
427
0
50
100
150
200
250
300
Excess Risk Associated with Not Breastfeeding (%)
Adapted from Surgeon General’s Call to Action. http://www.surgeongeneral.gov/topics/breastfeeding/
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Breastfeeding… saves moneyReduces cost of care in baby’s 1st year of
life• 25% fewer ear infections• 60% fewer cases of diarrhea• 200% fewer admissions for pneumonia• Formula cost for 1 year $1,800
Reduces cost of care for lifetime – Mother/Child
• Less cancer, obesity and heart disease in mothers• Less SIDS, infection, obesity , diabetes, asthma
in children• If 90% of mothers exclusively breastfed at 6
months– Save $13 billion/year in the US– Prevent 911 deaths
Bartick M, and A Reinhold. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010 May;125(5):e1048-56. Epub 2010 Apr 5.
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Breastfeeding Rates - 2013
Ever BF 6 mo 12 mo Excl BF 3 mo Excl BF 6 mo0
10
20
30
40
50
60
70
80
90
77
49
27
38
16
74
49
23
47
24
82
61
34
46
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USMNHealthy People 2020 Goals
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http://www.cdc.gov/breastfeeding/pdf/2013BreastfeedingReportCard.pdf
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WIC Breastfeeding Rates
8274 74
61
49 46
34
2328
01020
304050
6070
8090
Initiation 6 months 12 months
Healthy People 2020GoalMN
MN WIC
MN rates CDC Breastfeeding Report Card, 2013. National Immunization Survey Data from 2010.MN WIC rates from WIC Summary Statistics Supplemental Report-Breastfeeding, Sept. 2010.
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Peer CounselingMakes A Difference!
• Improves initiation and duration rates among women in:– Disadvantaged populations– Varied cultural groups– Urban and rural settings
• Peer counseling has been used effectively in many WIC State and local agencies across the U.S.
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Who Are Peer Counselors?• Experienced breastfeeding mothers • Ideally a current or previous WIC client• Ideally from the same population group as
the that served by WIC• Enthusiastic about breastfeeding, and helping
other mothers enjoy a positive experience• Provide basic breastfeeding information and
support to WIC mothers
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The Power OfMother-To-Mother Connections
“That’s what it’s all about…moms helping moms.
WIC Peer Counselor
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How Peer Counselors Help• Serve as a model for breastfeeding• Establish a connection with the family• Help mothers prevent and manage common
concerns with breastfeeding• Provide ongoing encouragement to help mother
meet her breastfeeding goals• Link to breastfeeding help beyond the
usual 8-to-5 services• Fill the gap in services immediately after hospital
discharge for seamless continuity of care
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WIC Healthcare Team
• As part of the WIC healthcare team, peer counselors:– Free up staff time by taking time to help mothers
explore and address barriers and concerns– Make referrals to WIC staff if mother has questions
or concerns outside her scope– Promote WIC with participants and family members,
encouraging participation– Provide information for WIC team that affect health
and nutritional status of client and her children
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USDA’s Vision ForPeer Counseling
• Institutionalize peer counseling as a core service in WIC
• Provide leadership and resources to equip State and local WIC agencies with implementing peer counseling programs
• Two training curricula for WIC agencies– “Using Loving Support to Manage Peer
Counseling Programs”– “Loving Support Through Peer Counseling”
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Basic Job ResponsibilitiesFor Peer Counselors
• Accept referrals of pregnant and breastfeeding WIC clients for follow-up
• Contact women at critical intervals– Monthly during pregnancy– Frequently during early days of breastfeeding– Monthly as long as baby is breastfeeding
• Be available to mothers beyond usual WIC clinic hours
• Document all contacts with mothers• Make referrals of women with concerns
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Job Settings
• Telephone calls from home and the clinic
• Clinic visits • Home visits• Hospital visits
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Peer Counselor Training• Attend training about
breastfeeding basics and how to provide support
• Personal study • Observe/shadow a lactation
professional (such as an IBCLC or senior peer counselor)
• Observe WIC nutritionist• Ongoing training
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Compensation
• Paid hourly for all contacts made with WIC participants, including documentation 5 – 12 hours per week $10 – 18 per hour
• Complete bi/weekly activity reports and submit to supervisor - timesheets
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SupervisionPeer counselors are:• Supervised by local
agency coordinator• Receive weekly contacts
from supervisor• Attend regular Peer &
WIC staff meetings• Complete contact logs • Have work pot checked
MN WIC Agency Peer Programs:
HennepinSt. Paul RamseyNE MN (6 counties, Grand Portage)AnokaBloomingtonFillmore/HoustonFond du Lac Band GoodhueOlmstedScott Carver CAPFreebornMille Lacs CountySWHHS (6 counties)
Partnerships!
• WIC Peer Counselor & CHW role• Agencies that have CHWs
– Hospitals– MVNA– Community clinics
• Serving pregnant and new mothers• WIC Training
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