Golden Start Golden Start Breastfeeding InitiativeBreastfeeding Initiative

Leslie Anderson RN, PHN

Laura Pearson RN, PHN

OverviewOverview

Public Health Agencies in 9 counties and 10 Public Health Agencies in 9 counties and 10 Hospitals in our region have partnered together Hospitals in our region have partnered together to form the Golden Start Initiativeto form the Golden Start Initiative Becker, Clay Douglas, Grant, Otter Tail, Pope, Becker, Clay Douglas, Grant, Otter Tail, Pope,

Stevens, Traverse, and WilkinStevens, Traverse, and Wilkin

Grant RegionGrant Region

EducationEducation

This project focuses on educating healthcare staff, in This project focuses on educating healthcare staff, in order to provide families with current, correct, order to provide families with current, correct, evidence-based information regarding feeding their evidence-based information regarding feeding their babiesbabies

Evergreen PerinatalEvergreen Perinatal Two 3-day coursesTwo 3-day courses

Over 120 nurses trainedOver 120 nurses trained

One 5- day Train-the-trainerOne 5- day Train-the-trainer Ability to reach 42,000 women of childbearing ageAbility to reach 42,000 women of childbearing age

Clinic educationClinic education

PoliciesPolicies

This project focuses on developing or This project focuses on developing or enhancing lactation friendly enhancing lactation friendly policies policies in the in the clinic, hospital, and public health arenas by clinic, hospital, and public health arenas by encouraging our partners to work towards encouraging our partners to work towards achieving the “Ten Steps” of the Baby achieving the “Ten Steps” of the Baby Friendly Hospital Initiative and the Friendly Hospital Initiative and the Breastfeeding Friendly Public Health Breastfeeding Friendly Public Health Department projectDepartment project

Businesses and DaycaresBusinesses and Daycares

This project focuses on connecting with local businesses in order to assist them in complying with state and federal statutes regarding lactating employees

Business Case for BreastfeedingBusiness Case for Breastfeeding All partner counties have PHNs trained All partner counties have PHNs trained Will connect with businesses and daycares in Will connect with businesses and daycares in

regionregion

History of Golden StartHistory of Golden Start

The Golden Start Intervention, which was fashioned after a NICU study done by Paula Meier @ Rush University, encourages & supports mothers to commit to at least 4 weeks of mother’s milk for their infants

10 Steps to Successful Breastfeeding10 Steps to Successful Breastfeeding

Step 1. Maintain a written breastfeeding policy Step 1. Maintain a written breastfeeding policy that is routinely communicated to all health care that is routinely communicated to all health care staff.staff.

Step 2. Train all health care staff in skills Step 2. Train all health care staff in skills necessary to implement this policy.necessary to implement this policy.

Step 3. Inform all pregnant women about the Step 3. Inform all pregnant women about the benefits and management of breastfeedingbenefits and management of breastfeeding..

Step 4. Help mothers initiate breastfeeding within Step 4. Help mothers initiate breastfeeding within one hour of birthone hour of birth

Step 5. Show mothers how to breastfeed and how Step 5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated to maintain lactation, even if they are separated from their infantsfrom their infants

10 Steps - continued10 Steps - continued Step 6. Give infants no food or drink other than Step 6. Give infants no food or drink other than

breastmilk unless medically indicatedbreastmilk unless medically indicated Step 7. Practice rooming-in – allow mothers and Step 7. Practice rooming-in – allow mothers and

infants to remain together twenty-four hours a infants to remain together twenty-four hours a dayday

Step 8. Encourage breastfeeding on demandStep 8. Encourage breastfeeding on demand Step 9. Give no pacifiers or artificial nipples to Step 9. Give no pacifiers or artificial nipples to

breastfeeding infantsbreastfeeding infants Step 10. Foster the establishment of breastfeeding Step 10. Foster the establishment of breastfeeding

support groups and refer mothers to them on support groups and refer mothers to them on discharge from the hospital or clinicdischarge from the hospital or clinic

The Golden StartThe Golden Start

Rush University Study Rush University Study

+ +

10 Steps to Successful Breastfeeding 10 Steps to Successful Breastfeeding

==

Golden Start InitiativeGolden Start Initiative

Influences on Healthcare SettingInfluences on Healthcare Setting

HospitalsHospitals Baby Friendly AssessmentBaby Friendly Assessment

www.babyfriendlyusa.orgwww.babyfriendlyusa.org

Public Health DepartmentsPublic Health Departments Breastfeeding Friendly AssessmentBreastfeeding Friendly Assessment

Wisconsin Division of HealthWisconsin Division of Health www.dhs.wisconsin.gov/health/Nutrition/Breastfeeding/departments.pdfwww.dhs.wisconsin.gov/health/Nutrition/Breastfeeding/departments.pdf

Assessment posted on MBC websiteAssessment posted on MBC website

More Steps CountMore Steps Count

Maternity care practices: implications for Maternity care practices: implications for breastfeedingbreastfeeding

DiGirolamo AM, Grummer-Strawn LM, Fein DiGirolamo AM, Grummer-Strawn LM, Fein S. Center for Disease Control S. Center for Disease Control

Conclusion: “Increased Baby-Friendly Conclusion: “Increased Baby-Friendly Hospital Initiative practices improve the Hospital Initiative practices improve the chances of breastfeeding beyond 6 months.”chances of breastfeeding beyond 6 months.”

Baby/Breastfeeding FriendlyBaby/Breastfeeding Friendly

Most important stepsMost important steps Step 3. Inform all pregnant women about the Step 3. Inform all pregnant women about the

benefits and management of breastfeedingbenefits and management of breastfeeding.. Step 4. Help mothers initiate breastfeeding Step 4. Help mothers initiate breastfeeding

within one hour of birth within one hour of birth Step 10. Foster the establishment of Step 10. Foster the establishment of

breastfeeding support groups and refer mothers breastfeeding support groups and refer mothers to them on discharge from the hospital or clinicto them on discharge from the hospital or clinic

Golden Start InterventionGolden Start Intervention

Prenatal intervention at first WIC appointment Prenatal intervention at first WIC appointment Golden Start Brochure given and discussedGolden Start Brochure given and discussed

Prenatal intervention at third trimester WIC Prenatal intervention at third trimester WIC appointmentappointment Colostrum Brochure given and discussedColostrum Brochure given and discussed

Follow-up Phone CallsFollow-up Phone Calls Immediate post-partumImmediate post-partum 10 days after first call10 days after first call

Golden Start InterventionGolden Start Intervention

Originated in Otter Tail County WIC Originated in Otter Tail County WIC populationpopulation

Shared at PH Directors meetingShared at PH Directors meeting Other counties wanted to replicateOther counties wanted to replicate Grant application written to include 9 countiesGrant application written to include 9 counties

BrochuresBrochures

Golden Start BrochureGolden Start Brochure Colostrum BrochureColostrum Brochure

www.noodlesoup.comwww.noodlesoup.com Distribution TimesDistribution Times

WIC appointmentsWIC appointments Clinic visitsClinic visits Hospitals – post-partum teachingHospitals – post-partum teaching Post-partum PH contactPost-partum PH contact

Golden Start FocusGolden Start Focus

SupportSupport Follow-upFollow-up Connection with resources in the communityConnection with resources in the community Customized brochures for each county with Customized brochures for each county with

contact phone numberscontact phone numbers

EvaluationEvaluation

Focus GroupsFocus Groups Clinic SurveysClinic Surveys Baby Friendly Hospital Initiative AssessmentsBaby Friendly Hospital Initiative Assessments Breastfeeding Friendly Public Health Breastfeeding Friendly Public Health

Department AssessmentsDepartment Assessments Pre-training surveys Pre-training surveys

Connection/NetworkingConnection/Networking

MN Breastfeeding CoalitionMN Breastfeeding Coalition SHIP Conference & QI Collaborative SHIP Conference & QI Collaborative Believers in Breastfeeding—Douglas County Believers in Breastfeeding—Douglas County Becker County Breastfeeding CoalitionBecker County Breastfeeding Coalition Fargo/Moorhead Breastfeeding CoalitionFargo/Moorhead Breastfeeding Coalition

Golden Start InitiativeGolden Start Initiative

Laura Pearson, RN, PHNLaura Pearson, RN, PHN Leslie Anderson, RN, PHNLeslie Anderson, RN, PHN

Project CoordinatorsProject Coordinators

218-736-8625218-736-8625

712 Cascade St. S. Fergus Falls MN 56537712 Cascade St. S. Fergus Falls MN 56537

goldinit@lrhc.orggoldinit@lrhc.org