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Breastfeeding Rates Increase in Georgia for 2014

The CDC has just released the Breastfeeding Report Card for 2014.  The good news for Georgia is that our breastfeeding rates are increasing.  We went from 68.2 ever breastfed in 2013 to 70.3 in 2014.  Georgia still lags behind the national rate of 79.2 ever breastfed.  We have also made strides in breastfeeding duration until 6 months.  Those numbers increased by 8.3%.  This increase may be in part due to The Georgia 5-STAR Hospital Recognition Program that was launched by the Department of Public Health.  This program supports activities that recognize hospitals as they move toward Baby-Friendly® designation.   Georgia has provided funding for 7 hospitals.   For more information on the 2014 Breastfeeding Report Card, click here.


SHAPE Initiative Seeks Applicants for Second Round of 5-STAR Funding

DPH has extended the timeline to apply for the second launching of the Georgia 5-STAR Hospital Initiative. 

The new date to complete and return the application is 4/11/2014.

The Georgia SHAPE Initiative announces the second round of funding for the Georgia 5-STAR Hospital Recognition Program.  This program will support activities to recognize hospitals as they move toward Baby-Friendly® designation.  One star will be awarded for every two steps implemented of The Ten Steps to Successful Breastfeeding, as defined by Baby-Friendly USA, the official credentialing agency of the Baby-Friendly Hospital Initiative (BFHI). Hospitals will be required to complete the Georgia Breastfeeding Program-Scorecard Tool to receive stars.

The BFHI is a WHO/UNICEF program that encourages and recognizes hospitals that offer optimal promotion and support for breastfeeding, including supportive hospital policies and practices, staff education and post-discharge community referrals, collectively referred to as The Ten Steps to Successful Breastfeeding.

The program will provide funding opportunities for up to six (6) Georgia hospitals.  Applicants are eligible to receive up to $7,000.00 to defray costs associated with improving the quality of maternity care related to breastfeeding and pursuing Baby-Friendly® designation. The Georgia Department of Public Health will provide a one-week Train-the-Trainer session for hospital staff and monthly technical support from BFHI experts.  Successful applicants will demonstrate intent to create policy, practice and environmental improvements within their hospital to support their BFHI efforts.

The $7,000.00 award may be used to pay the required fees for the 4-D Pathway to Baby-Friendly Designation or to provide reimbursement for costs associated with staff training and travel to attend the required two (2) one (1) day Collaborative Learning Sessions and one (1) five (5) day Train-the-Trainer Session.

Up to (6) successful applicants will be selected and will represent:


  • Strong institutional capacity and support of executive leadership
  • Institutions serving a high percentage of minority and Medicaid-eligible families
  • Institutions with low breastfeeding initiation rates and high rates of pre-discharge formula supplementation of breastfeeding newborns
  • Institutions serving a culturally diverse population
  • A variety of geographic areas, including rural and medically underserved regions
  • Hospitals at various stages of implementation of the Ten Steps to Successful Breastfeeding (see Appendix A)
  •  Various hospital classification levels (e.g., regional perinatal center, etc.)


Application available on the Georgia SHAPE website - deadline MARCH 28! 


Neighboring States Support Breastfeeding Mothers

Virginia has  a bill that will provide teachers and other school employees with a private area to pump during the workday has been approved by the Virginia House Education Committee and will now go to the full Virginia House of Delegates.  The ACA does require that businesses support breastfeeding mothers when they return to work by providing them time and a place to pump.

The Tennessee Department of Health has launched the Tennessee Breastfeeding Hotline, staffed by Lactation Consultants and operated in partnership with Le Bonheur Children's Hospital in Memphis. Hotline staff members are available 24 hours a day, seven days a week to assist breastfeeding mothers and partners, their families, expectant mothers, and health care providers seeking breastfeeding support and information. 

     

The Affordable Care Act and Breastfeeding Support

There is new information on the AAP website about what the Affordable Care Act (ACA) provides to breastfeeding mothers to assist them in meeting their breastfeeding goals: (1) Businesses should offer breastfeeding mothers time and a place to pump while they are at work (2) Health insurance benefits should cover costs of pumps and lactation support that assist breastfeeding mothers to continue to breastfeed.  The AAP wants pediatricians to be aware of what support breastfeeding mothers should receive from the ACA.  For more information go to the AAP Breastfeeding Initiative page on the www.aap.org website.


Breastfeeding Opportunity

DNPAO is recruiting for a Breastfeeding Fellowship located in the Nutrition Branch.  Applicants must have completed a Master’s or Doctoral degree within the last five years to be eligible.  The position description and application information are available at orau.org. 


Hepatitis C (HCV) and Breastfeeding

The CDC does not consider chronic hepatitis C infection in the mother a contraindication to breastfeeding.  Studies have never been able to document horizontal transmission of HCV by breast milk.  We now have new information from a study done in Germany that was published September 2013 in The Journal of Infectious Disease that discussed a plausible reason why babies don’t get HCV from breast milk.  According to the article, “A new finding is that lipase in human milk generates free fatty acids that damage the viral envelope and render them non-infectious”.  This antiviral activity was specific to human milk and was not destroyed even when heated.  Dr. Steinman concluded that unless the mother has cracked bleeding nipples she should be breastfeeding.


AAP ADVISES MOST MEDICATIONS ARE SAFE FOR BREASTFEEDING MOTHERS.

Most medications are safe for breastfeeding mothers and their babies according to a clinical report titled, “The Transfer of Drugs and Therapeutics Into Human Breast Milk”, published in the September 2013 Pediatrics.  The American Academy of Pediatrics (AAP) provides guidance to physicians regarding drug exposure and reaffirms the recommendation that most medications and immunizations are safe during lactation. It is important for breastfeeding mothers to inform their child’s pediatrician about all of the medications they are taking, including herbal products. Physicians can obtain the most up-to-date information on drugs and lactation from the National Institutes of Health (NIH) which provides an online database available at LactMed

A new benefits page on HealthCare.gov explains how the Affordable Care Act impacts breastfeeding families. 

The CDC has just published their 2013 Breastfeeding Report Card for the United States. Nationally 77% of all mothers are choosing to breastfeed their infant.  We lag behind in Georgia where only 68% of Georgia mothers are choosing to breastfeed.  Are we failing the mothers that choose to breastfeed since only 6% are exclusively breastfeeding at 6 months?   Exclusivity is important for keeping up the mother’s milk supply as well as helping to keep moms and babies healthy.  Maybe many are weaning early because as many as 27% are being supplemented before 2 days of age.   To read more about the report, click here.

Healthy Mothers, Healthy Babies are sponsoring a “Lunch and Learn” about Licensure of IBCLC’s in Georgia. The luncheon will be held at Wellstar Kennestone Hospital. Find out how this can help your practice. For more information click here
                                 
A new study was just published in Obstetrics & Gynecology about the economic costs of not breastfeeding.  The article shows the result of a sophisticated statistical model used to compare the effect of current breast-feeding rates in the U.S. to ideal rates.  The results showed that suboptimal breastfeeding incurs a total of $17.4 billion in cost to society resulting from premature death, $733.7 million in direct costs, and $126.1 million in indirect morbidity costs.  To read more, go to Time.com.

The Academy of Breastfeeding Medicine's new Clinical Protocol #14: Breastfeeding-Friendly Physician's Office: Optimizing Care for Infants and Children, Revised 2013 presents 19 recommendations intended to improve physician support of breastfeeding initiation and duration. Among the recommendations are guidelines for establishing a written breastfeeding-friendly office policy, providing culturally and ethnically competent care related to lactation, introducing the subject of breastfeeding during the first trimester of pregnancy, allowing and encouraging breastfeeding in office waiting rooms, educating clinical physicians and staff on the benefits of breastfeeding, and encouraging enforcement and adoption of workplace laws that support breastfeeding. Read the press release.

NICHQ (National Initiative for Children's Healthcare Quality) has launched a new website and home base with news, strategies, and tools to help birthing facilities improve maternity care to better support mothers who choose to breastfeed.

Surgeon General, Regina Benjamin, MD announced the launch of“It’s Only Natural” a breastfeeding education campaign targeted to African-American mothers.  This campaign hopes to provide these mothers with practical information on breastfeeding as well as information on how they can make breastfeeding work in their lives. 

To learn more about the campaign, visit www.womenshealth.gov/ItsOnlyNatural. Follow HHS on Twitter @HHSgov.

Breastfeeding Updates

Rhode Island is the First State to License the IBCLC! 

Through the efforts of the Rhode Island Breastfeeding Coalition (RIBC) and legislative champion Senator Gayle Goldin, the distinct role of the IBCLC has been recognized by Rhode Island state law as the only credential able to practice under the title of "lactation consultant". 

Georgia is also working toward licensure of lactation consultants.  Healthy Mothers Healthy Babies is working hard to educate our legislators and others on the benefits of having licensed, IBCLC, lactation consultants.  Our hope is that licensure will increase access to breastfeeding support for Georgia.


No Free Formula?  More Breastfeeding!

Jennifer Nelson, MD, a pediatrician, and one of our EPIC trainers had an article published in the June Pediatrics titled, “Trends of US Hospitals Distributing Infant Formula Packs to Breastfeeding Mothers, 2007 to 2013”.  Dr. Nelson, a mother of three, knows firsthand how important it is to have breastfeeding support in the hospital.  The numbers show that less an a third of US birthing hospitals in 2013 were giving out free formula samples, down from almost 73% in 2007.  There are many studies that show breastfeeding duration rates suffer when mothers are offered “free” samples of formula.  Read her article in June’s issue of Pediatrics for more information.

EMPower Breastfeeding Initiative Hospital Recruitment Webinars, from CDC and the EMPower Team
The Centers for Disease Control and Prevention has launched EMPower Breastfeeding: Enhancing Maternity Practices (EMPower), a three-year hospital-based quality improvement initiative focusing on maternity practices. Developed in partnership with Abt Associates, Carolina Global Breastfeeding Institute, Center for Public Health Quality, and Baby-Friendly USA, EMPower is designed to support 100 hospitals in the achievement of Baby-Friendly USA designation. Hospitals will be selected to participate based on set criteria designed to address issues of equitable access to maternity care that optimally supports mothers to be able to breastfeed. The application will be available on the EMPower website by February 18 at 3 p.m. ET. Hospital Recruitment webinars will be held on February 24 at 3 p.m. ET and February 26 at 2 p.m. ET. For additional information on the initiative and how hospitals can apply, please visit EMPowerbreastfeeding.org.


Georgia Hospitals Receive CDC’s 2013 mPINC Scores 

The 2013 CDC Survey results are out for Maternity Practices in Infant Nutrition and Care (mPINC).  The mPINC survey is a national survey from the CDC that assesses infant feeding care processes, policies and staffing knowledge in maternity care settings.  All hospitals in the US are invited to participate and each facility receives their own private report.  They are able to evaluate how they are doing on maternal/infant care at their facility and compare their scores with others in their state and the US.  This survey is sent out every 2 years.

Georgia ranks “45” in the nation and received an overall score of “69”.  Although Georgia improved on many areas they are still lagging behind other states in the US.  For more information on Georgia’s survey results click here.


Requirements for Pregnancy and Lactation Labeling

The Food and Drug Administration (FDA) just released a new rule on labelling of medication safety during pregnancy and lactation. The final rule requires the removal of the pregnancy categories A, B, C, D, and X from all human prescription drug and biological product labeling. It will require that the labeling include a summary of the risks of using a drug during pregnancy and lactation, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy and lactation.  This rule is effective June 30, 2015.  Click on the here for more information.


It's Open Enrollment Time!

Did you know that breast pumps and breastfeeding supplies are a qualifying expense under FSA and HSA guidelines? If you have patients who are currently pregnant, let them know they should be able to get a breast pump and breastfeeding supplies.

What are FSAs and how can moms use them?

  • Flexible spending accounts (FSAs) allow you to designate a portion of your paycheck to cover certain types of expenses, such as prescriptions or doctors’ visits. The money is deducted before taxes are taken out, which brings down your total taxable income.
  • While the Affordable Care Act requires insurers to cover the cost of a breast pump, some pumps cost more than what the health plan will pay. In these cases, it may be necessary to cover the cost of an upgrade to get the pump you want. 
  • You can use FSA funds to pay for a pump upgrade or to get a second pump for use at work or while on the go. And, to purchase new parts, additional breast milk storage bags or other breastfeeding supplies, you can use FSA funds for that as well. 
  • Whether for healthcare visits or breastfeeding supplies, here are a few tips to get the most from your FSA account: 
    • Plan for next year now. You can allocate up to $2,500 to your healthcare FSA each year. If you are pregnant or breastfeeding, consider allocating funds to your FSA so that you can get your breastfeeding supplies with pre-tax dollars. 
    • Know your timeline. You may be allowed a 2½-month “grace period” to use money from an FSA, after the calendar year ends — check with your employer. 
    • Check your balance. Don’t let any of your annual funds go to waste. Ask your employer if you are able to carry over unused funds, up to $500, to the next calendar year.


(Source: https://www.healthcare.gov/can-i-use-a-flexible-spending-account-fsa/).

What are HSAs and how can they support breastfeeding?

Health Savings Accounts (HSAs) cover qualified medical expenses.

Breastfeeding supplies, including pumps, storage bags and other accessories can be purchased using funds in HSAs.

Parameters vary so check with your employer before applying funds from an HSA.

An HSA is similar to an FSA except that it is for people with a high deductible health plan and your money rolls over from year to year.

An individual can allocate up to $3,350 pre-tax and a family can allocate up to $6,650 (for 2015).

(Source: http://www.irs.gov/publications/p502/ar02.html#en_US_2013_publink1000256742;http://www.towerswatson.com/en-US/Insights/Newsletters/Americas/insider/2014/irs-announces-2015-hsa-limits)

Georgia Makes Great Improvements on CDC’s mPINC Scores

The CDC has released their 2015 Maternity Practices in Infant Nutrition and Care (mPINC) scores.  Their scores reflect:  Policies, practices and protocols that rate staff trainings, infant feeding care, infant supplementation and support after discharge from the hospital.  All nationwide hospitals and birthing center are asked to participate in the survey. 

The survey assists hospitals in making sure they are meeting the Joint Commission Perinatal Care Core Measure breastfeeding requirements and ensure that the hospitals are training staff in infant feeding care.  They also want states to celebrate their Baby Friendly Hospitals and show other hospitals how to use the 10 steps to improve care.  Georgia had no Baby Friendly Hospitals in 2013 and we now have 6 in 2016. 

Scores in Georgia increased in every category.  Georgia’s score increased from a 69 in 2013 to a 75 in 2015.  Our ranking nationally increased from 45th in the nation to 38th.  We are making great strides in getting all babies skin to skin after delivery and assisting moms to breastfeed within the first hour of birth. Way to go Georgia Hospitals!


Georgia Becomes Second State in Nation to License Lactation Consultants

Atlanta, Georgia - May 2, 2016 - Governor Nathan Deal has signed into law HB 649, the Georgia Lactation Consultant Practice Act, making Georgia the second state, after Rhode Island, to license lactation consultants.

Federal law requires coverage for lactation services, but many insurance companies will only pay for the services of licensed healthcare professionals. Lack of insurance reimbursement has made clinical breastfeeding care prohibitively expensive for many. "We are grateful to Representative Sharon Cooper for working tirelessly to pass this important legislation," stated Leah Aldridge, JD, IBCLC, president of Healthy Mothers, Healthy Babies Coalition of Georgia (HMHB). "This law will increase access to clinical lactation care for Georgia's mothers and ensure the healthiest possible start in life for Georgia's babies."

Seventy-four percent of Georgia's mothers leave the hospital breastfeeding, but only 19% are successful in meeting the American Academy of Pediatrics (AAP) recommendation of exclusively breastfeeding their babies for the first six months.

Research shows that mothers who have access to lactation consultants have much higher initiation and duration rates of breastfeeding. Breast milk provides many health benefits to babies, including reducing the risks of obesity, type 2 diabetes, ear infections, SIDS, leukemia, asthma, gastrointestinal disorders such as inflammatory bowel disease and deadly necrotizing enterocolitis.

Practitioners seeking licensure to provide clinical lactation care will be required to become International Board Certified Lactation Consultants (IBCLCs), with prerequisites that include lactation specific training, college coursework, clinical hours, passage of a comprehensive exam and regular re-certification.

"We are thrilled that by passing this landmark legislation, Georgia has become a national leader in breastfeeding support," says Elise Blasingame, Executive Director of HMHB. "We are very thankful for the efforts of our medical and community partners to make this a reality for Georgia's families."


Grady Hospital has just received the Baby Friendly Designation! 

They are the fourth hospital in Georgia to have this distinction.  The Baby-Friendly Hospital Initiative (BFHI) is a global initiative that was started by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of infant care and feeding and mother/baby bonding. They recognize and award hospitals and birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding. 

The other Baby Friendly hospitals in Georgia are Emory @ Midtown, DeKalb Medical Center, Doctors Hospital in Augusta, and now Grady Health Systems.  Way to go Grady!