STANDARDIZED COMMUNITY-BASED
BREASTFEEDING SUPPORT
Author: Lucia Jenkins RN, IBCLC, RLC
Mission Statement :
To promote and support the development of community-based,
breastfeeding support sites offering on-going, high-quality lactation
care free-of-charge to breastfeeding families
L U C I A J E N K I N S R N , I B C L C , R L C
E X E C U T I V E D I R E C T O R B A B Y C A F É U S A
B A B Y C A F É U S A . O R G
L U C I A @ B A B Y C A F É U S A . O R G
Delta Hills Mississippi Lynn Mass Buffalo NY
Executive Director/
Founder
Staff/Admin Volunteers
Danielle Lugrand CLC
Oklahoma
Portia Williams RN, IBCLC
Louisiana
Daniel Lieber
Board member
Business Advisor
Tom Jenkins
Board Member
Treasurer
Craig Smith
Data Analysis/
Development
James George,
CPA, JD
Board member
Legal Counsel
Patricia Loewy
BCBC Curriculum
Coordinator
Lauren Liecau
Web Maint.
Christine Staricka, IBCLC
California
Media Contact (w /granddaughter Savannah)
Lucia Jenkins RN, IBCLC, RLC
State Coordinators
Volunteer Board
Staff
Katie Barnes, PhD
Board Member
Admin/Research
Calderdale Baby Café cited as an example
of best practice in Department of Health
publication: Tackling Health Inequalities in
Infant & Maternal Health Outcomes, report
of the Infant Mortality National Support
Team (DoH 2010)
Introduction to Baby Cafe USA; El Paso
Baby Cafe: Peer Support for Lactation Care,
Mothers, and Babies (Clin Lactation; Vol. 4,
Issue 3, 2013)
Breastfeeding-Friendly Erie County:
Establishing a Baby Café Network;(J Hum
Lact Nov 2015)
A free, drop-in, community-based breastfeeding
support site following a proven model
A Baby Café is:
How does a Baby Café differ from a breastfeeding support group?
Support groups are variable
no standard of care
CONSISTENCY = VALIDATION AND TRUST
Trusted by both mothers and health
professionals
Offers qualified site for training of peer
counselors/ IBCLC ccandidates
FUNDED BY MULTIPLE COMMUNITY
ORGANIZATIONS
Surgeon Generals Call to Action: Act 4-Use
community-based organizations to promote and
support breastfeeding.
EL PASO
MALDEN
FAMILY
ORGANIZATION
PROVISION PEOPLE
PLACE
REVIEW
The Model
2017
87 Baby Cafes
24
States
USA – 2011
Formation
Baby Café USA
USA
2008-2010 Texas,
Georgia, Malden WIC, Everett WIC
USA- 2007
Melrose-Wakefield Baby Café
UK- 2000
Pilot #1 Drop-in
3 10 12
28
40
58
78
87
0
20
40
60
80
100
2010 2011 2012 2013 2014 2015 2016 2017
BABY CAFÉ GROWTH IN USA
Baby Cafes
Organization Development
87 US Baby Cafés – 10/2017
2016 Total Attendances @ US Cafés: 15,110
Avg Number Moms per café meeting: 7.6
New moms : 5,101
Pregnant moms: 1,455
Longer running cafés have > numbers
Numbers often are determined by space/frequency of meetings
• Massachusetts – 12
• Texas – 14
• Michigan – 1
• Minnesota – 8
• Pennsylvania – 2
• Florida – 4
• California-1
• Missouri- 1
• New York – 13
• Wisconsin – 3
• Ohio – 1
• Connecticut- 1
• Alabama – 5
• Oklahoma- 4
• Rhode Island -1
• S Dakota – 1
• Maryland- 2
• Arizona- 1
• Louisiana – 1
• Mississippi – 4
• North Dakota – 1
• Georgia – 2
• Virginia - 2
WHO (World Health Organization)
Globally 38% of infants @ 6 months are exclusively breastfed
2025 TARGET: Increase exclusivity @ 6 months to 50%
US (CDC Bfeeding Report Card) Nationally 22.3% of infants @ 6 months are exclusively breastfed
2020 TARGET : Increase exclusivity @ 6 months to 25.5%
ACTION: Provide Access To Support - Reduce Disparities
Engage the local public in supporting breastfeeding moms
Utilize community resources for
optimal outcomes
Grants, WIC, ROSE, Hospitals, DPH
Libraries, Churches, Health Collaboratives
Baby Cafés Align with Local and Global Initiatives
All cafés follow standards set by Baby café USA
Usually supported by a known establishment (hospital, clinic, WIC )
IBCLC care for complicated situations
WHO-Code Compliant
Satisfies step 10 of BFHI
Part of a network, sharing good practice
National & local recognition
Grand Opening required
Statistical data gathering and assessing
Provision of Service
Universal, free, high quality service for all breastfeeding women
All Cafés are required to collect data- forwarded to BCUSA
Webinar Training
Custom Forms w/ self-generating graphs for each Cafe
Data collection
Exclusivity at Café
Mother’s Duration Goal @ 1st Visit
Demographics at Café
Mom’s SURVEY
Duration, cause of weaning
Use of formula, rating of Café
Annual Café Operation Survey
Survey Monkey from BCUSA
PROGRAM REVIEW
*Source: Centers for Disease Control and Prevention National Immunization Survey, Provisional
Data, 2016. http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm
Baby Café Moms Survey
(2 cafés)
infants > 1 year of age
Cafe Rates
Vs
CDC Massachusetts data
**CDC is NOT a control group)
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
>6 Wks <= 3 Mos >3 Mos <= 6 Mos >9 Mos <= 12 Mos
82.7%
76.7%
65.3%
49.2%
19.9%
38.7%
MA BC Rates
MA CDC Rates
Baby Café Moms Survey
goals
Babies >= One Year of Age
Attendance:
< 5 visits
Vs
>5 visits
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
All < 5 Visits >= 5 Visits Prenatal Attendees
20.7%
27.1%
17.6%
0.0%
77.3%
66.7%
82.4%
66.7%
66.0%
58.3%
69.6% 66.7%
Fell Short of Own Goal
Met or Exceed Own Goal
Met AAP Goal (1YR)
2016 Delta Hills Café
Demographics
Ethnicity
Education
% WIC
% Work
% W/ 1st Child
15.38%
0.00%
0.00%
84.62%
0.00% 0.00% 0.00%
CAUC
HISP
ASIAN
BLACK AMER
INDIAN
BLACK OTHER
Other
69.23%
23.08%
0.00% 7.69%
HIGH SCHOOL OR GED
COLLEGE DEGREE
POST GRAD DEGREE
IN SCHOOL
40.00%
30.00%
30.00%
# USING WIC
# WORKING OUTSIDE HOME
# WITH FIRST CHILD
A group of 2-5 Baby Cafes in a general area ie: Circle of Moms Baby Café – KDMC ; Circle of Moms Baby Café – Brookhaven Library
Share the same licensed name
Approved "pool" of staff facilitating all the cafe sites
Separate applications are filled out for each site- no charge to apply
separate info and individual web pages
One training done for all staff together
One lead facilitator listed for communications with BCUSA One set of combined data gathered and sent to us
Set-up fee: $750 for the lead cafe
$150 fee for each other site (covers the administrative set up for each site)
Yearly license renewal is $150 for the lead cafe + $100 for each added site
The Café Cluster Model
Baby Café Breastfeeding Counselor (BCBC)
Training Program
Breastfeeding Counselor Training Program
• Improves opportunity for local women/CLCs/RNs
•Enables cultural change
•Utilizes community resources
•Comprehensive program
• Leadership opportunity for IBCLCs
•Mentoring by Café Facilitators
•Sliding fee- starts at $100
•Qualifies for hours for IBCLC exam
• Potential Facilitators for new Cafes
HOW TO SET UP A BABY CAFÉ
Getting Started
The Place
Welcoming Cafe Style
Inclusive
Safe - All staff identified with nametags
Attractive, upbeat name and logo
Casual, comfortable surroundings
Positive sensory aspects, refreshments
Mainstream - going to a Café is socially normal
Locations:
Church Halls, Clinics, and Community Centers
Mobile Minibus
Libraries!!
Accessibility
No prior sign-up or time period commitment
Accessed by moms considered ‘hard-to-reach
On/near public transportation
Flexible! Many variations Can be designed to fit individual community profiles
The People
Multi-disciplinary support team, multiple
members
IBCLCs
Peer Counselors, CLCs, CLS, etc.
LLL Leaders, Volunteers
Variety- makes bridges over community gaps
Promotes community volunteerism/involvement
Encourage links with Pedi/OB services
through moms/babies’ care
Promotion- Grand Opening
Connect health care and voluntary sectors
Community-based “feel”; familiar faces/friends
The “Stuff”
• License to operate Café on wall
• Digital scale -Pre/Post-feed weighing
• Moms report that it is very reassuring
• Qualified Facilitator to help them interpret
results
• Clipboards
• Drinks/Snacks - Mother’s milk tea
• Seating - Comfortable, wide, low arm
chairs/sofas
• Private space for one-on-one with moms
• Pillows - Lots of various pillows
• Nursing stools or footstools
$$$$FUNDING – For Staff/Supplies/Marketing
Funding…. What? Baby Café is CLOSED??
• Funding can come from a variety of sources
– National Health Grants
– Obesity Grants
– Health Boards, Local Healthcare Cooperatives
– WIC Programs
– Community Funds Or Grants, Rotary Clubs
– Perinatal Collaboratives
• Budgets run from $5000 - $20,000.00 per year
– Depends On frequency, Staff Salary
• Recommended:
Have Funding Sources lined up for a
minimum of 2 years
Online Resource Bank Password-Linked
For Facilitators- on BC web site
Baby Café Publications
Policies And Practice Guidelines
Samples And Templates
News Magazines And Bulletins
Annual Reports
Evaluating Your Baby Café
Shared Resources
Translated Resources
Health And Safety
NEW 2015- Facebook Forum for Facilitators
Baby Café Operation
Encourages positive attitudes – breastfeeding is “valuable”
Reliable and dependable presence
Helps moms prepare for their baby’s next stage
Peer Modeling –
Demonstrates “ breastfeeding works”, Peer Encouragement
Mothering shown by experienced moms
Education to continue for a year
Presented so the mom can absorb it, trained counselors
Current, correct information (research-based)
Informal - Encourages open questioning
Knowledgeable solutions to lactation issues
Referrals to other professionals if necessary (i.e. tongue tie, mastitis)
Assists with transition to work and pumping, ongoing weight issues
Exposure/Publicity
Notices:
Prenatally: Classes, WIC Office, OB, Pedi, Midwives Offices
Hospital Discharge Breastfeeding Packets
Waiting Areas At Local Hospitals, Clinics
Community Programs
City’s Welcome Packets - Town Officials (Mayor’s Office)
Hospital Newsletters, Newspapers
Local Cable Listings
Grand opening – within the first year- also include:
Newspapers
TV (Cable, Commercial News)
Community VIPs, Celebrities
Other:
Baby Stores Expos
Referrals On Discharge From Postpartum Units At Hospitals
Pediatricians, Local Hospitals, Clinics, Pediatric Websites
To see 20+ mothers in 2 hours and meet health outcomes for that family and community from many perspectives was excellent resource management.
(Baby Café Facilitator)
Baby Café Testimonials
Every mom should have a Baby Café. I wouldn’t be breastfeeding without it
(Sophie)
It made it possible for me to breastfeed for a year; I made friends I’ll have forever.
(Julie)
I left the hospital not knowing at all what I was doing! My baby had a tongue tie that the Café LC discovered.
Thank you for being there to help me get on track.
(Lindsay)
Thank you to all the moms and babies who so graciously agreed to be photographed for this presentation.
Photo- L Jenkins
Photographs used in this presentation may only be used with permission of the author