1. Change Package
Your Team Name: Clark County Combined Health District
Topic Area: Breastfeeding
Name of the Intervention: Breastfeeding Checklist to be completed with prenatal and breastfeeding mothers.
Primary Driver: Reliable and effective policies and practices supporting families through critical windows for breastfeeding decisions.

2. Definition of the Intervention
A breastfeeding checklist was assembled to include breastfeeding resources. The list was designed by topic and listed all resources (pamplets, booklets, etc…) available to the visitor, including an activity for each topic section. The checklist was designed to be used regardless of when the family was enrolled during their pregnancy.

3. Description of the Intervention-BF Checklist
Breastfeeding checklist
EDD:
Parent Name:
Prenatal
Date completed
Session 1
Suggested Activity-
Topic Areas
Breastfeeding Box
Benefits of Breastfeeding (mom and baby)
Basics around breastfeeding
Suggested Handout-
**Benefits of Breastfeeding
Provide-Breastfeeding Class List
Why Breastfeed?
Breastfeeding- Your guide to a healthy, happy baby
Breastfeeding- Information for new and expectant parents
Breastfeeding- A how to guide
Hugs and Health- Breastfeeding
Breastfeeding Tips
Tips on Breastfeeding
Breastfeeding Basics
Your Guide to Breastfeeding
Success with Breastfeeding
**10 Ways to get Breastfeeding off to a good start
Babies Were Born to Be Breastfed
Breastfeeding for Good Health
Session 2
Feeding Plan
Family support
Barriers
Dad and Baby
Skin to Skin
Dads and Breastfeeding
How Fathers Can Support Breastfeeding
Babies First: Families Support for Breastfeeding Mother
Ten Tips to Help Overcome Breastfeeding Hurdles

4. Session 3
Suggested Activity:
Topic Areas
Breastfeeding spin game (questions)
Milk Supply
Positions
Suggested Handout
Myths
How Breastfeeding works
Skin to Skin
Positions for Breastfeeding
Common Breastfeeding Myths
Myths and Facts around Breastfeeding
**Establishing Milk Supply
Keeping up your Milk Supply
Kangaroo Care
Session 4
Suggested Activity-
Baby cue cards
Cues for hunger and satiation
Breastmilk Composition and Colostrum spoon
Breastmilk composition
Suggested Handouts-
**How to tell when your baby is hungry
Breastmilk Composition
Session 5
Latch, preparing for breastfeeding,
Babies bellies display or pocket model
Positions during feeding
Video on breastfeeding
Baby Bellies
Diapers and Breastfed babies
Establishing Milk Supply
Getting Ready to Breastfeed
**Baby Bellies
Provide resources if supports needed
Is Baby getting Enough?
**Latching On
Diapers of the Breastfed Baby
Infant Feeding and Diaper Log

5. Postnatal Session 6 Suggested Activity- Topic Areas
Session 6
Suggested Activity-
Topic Areas
Ready, Set, Go Cards
Nutrition while Breastfeeding
Pump Activity
Is baby getting enough
Keeping up milk supply
Suggested Handouts
Pump and storage
Ten Healthy Habits while you are Breastfeeding
Nutrition and Breastfeeding
For Breastfeeding Moms
Breastfeeding When You Are Away
Breastfeeding and the Working Mom
Breastfeeding when you can’t be with your baby
A Guide to Pumping Your Milk
Babies First: Breastfeeding and Work or School
Storing Breastmilk Safely
Storing Human Milk
Session 7
Weaning
Introducing a bottle to your full term breastfed baby
How Long Will I Breastfeed?
How Long Should I Breastfeed My Baby?
Continued Breastfeeding and Starting Solids
Weaning Your Baby
Weaning from Breastfeeding
Session 8 (optional)
Troubleshooting
Ten Tips on Managing Breast Engorgement while Nursing
Are your Nipples Sore?
What is Reflux?

6. How is the intervention carried out?
1) Compile all available resources
2) Review all materials to determine that the information is consistent and accurate.
3) Compile checklist based on topic and include recommended activities that would support breastfeeding.
4) Organize the resources so staff can easily access the materials from the checklist.

7. Evidence that the intervention is effective
In total, 10 home visitors (all trained in Breastfeeding practices) were asked to use the checklist with families on their caseload where mom was breastfeeding or pregnant. Initially, only 2 home visitors were asked to use it. More home visitors were asked on the additional PDSAs. Also, several modifications were made on the form and more activities were developed. Home Visitor and family input was sought over the 5 cycles.
Home visitors completed the checklist with 18 families.
Home visitors all indicated that the list of materials and the way it was organized encouraged them to consistently talk about breastfeeding with families. Activities developed were also well liked by home visitors and families.

8. Pre-requisites for the intervention
-Educational Resources pertaining to a variety of Breastfeeding topics
-Staff were confident/skilled after completing the online WIC peer helper training and a day long training through the hospital.
-Staff commitment to use the checklist.

9. Advice Barriers / Challenges Key advice to overcome barriers
Time Consuming Process
Format took some time/thought to develop. Once developed, it was a matter of organizing and putting materials into a file for staff access and completing the checklist.
Staff using it consistently
We are attempting to monitor use is supervision. The checklist is in the file when a family is assigned as a reminder.

10. Adaptations (if applicable)
This was an organic checklist based on the concept of the Boston Toolkit. The toolkit was very specific and we wanted something more general to use with our families. This checklist could easily be adapted for use specific to the needs of the program.

11. References/ Inspiration (if applicable)
Boston Toolkit