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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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