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