1. Property of MN Department of Health/DeJong 1 Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students  Objectives 17: Providing support in a variety of settings  Objectives 18: Impact of public health  Objectives 19: Evaluation of own community – discuss ways to support breastfeeding where student works and lives

2. Objective 17 Discuss the role of the registered nurse in providing support to mothers in a variety of settings Property of MN Department of Health/DeJong2

3.  What can you do as a nurse if you are working in a clinic seeing pregnant moms before they deliver in the hospital? Property of MN Department of Health/DeJong3

4.  What can you do as a nurse if you are working in a hospital working with families who have just delivered? http://wicworks.nal.usda.gov/wicworks/resources/images.html Property of MN Department of Health/DeJong4

5.  Remind Dad/Partner that their assistance with breastfeeding and the care of baby is vital. Property of MN Department of Health/DeJong5

6.  Review the following website: http://www.co.otter- tail.mn.us/publichealth/goldenstart/ http://www.co.otter- tail.mn.us/publichealth/goldenstart/ Property of MN Department of Health/DeJong6

7. Objective 18 Discuss how public health programs in particular impact breastfeeding and education Property of MN Department of Health/DeJong7

8.  Through public funding from the “Communities Putting Prevention to Work Initiative,” several states and communities have expanded their breastfeeding promotional activities, hired additional staff (FTEs) and engaged new partners. For example, funded states and communities have worked with hospitals to improve maternity care practices and have provided guidance to hospitals seeking Baby-Friendly designation. They have also worked with employers and child care providers to help employed women continue to breastfeed. Property of MN Department of Health/DeJong8

9.  Promoted maternity care policies and practices that have increased breastfeeding rates.  Tracked hospital policies and practices that support mothers to be able to breastfeed.  Helped hospitals implement The Ten Steps to Successful Breastfeeding. Property of MN Department of Health/DeJong9

10. Image used with permission from http://wicworks.nal.usda.gov/wicworks/resourc es/images.html Property of MN Department of Health/DeJong10

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12.  Interventions are actions that PHNs take on behalf of individuals, families, systems, and communities to improve or protect health status. Property of MN Department of Health/DeJong12

13.  Nurse-led health promotion efforts that are perceived as primarily contributing to quality of life in the short run include, but are not limited to, breastfeeding support (Pugh, Milligan, Frick, Spatz, & Bronner, 2002), hypertension prevention and control (Hill et al., 2003), coronary heart disease (Allen et al., 2002), obesity and diabetes control (D'Eramo-Melkus et al., 2004). All of these examples are nurse administered and are public health interventions focused on changing health behaviors, particularly promoting positive health behaviors, relevant to morbidity. Property of MN Department of Health/DeJong13

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15. Objective 19 Evaluate the factors that impact breastfeeding in your community and discuss ways to support breastfeeding where you work and live Property of MN Department of Health/DeJong15

16. Image used with permission from http://wicworks.nal.usda.gov/wicworks/resour ces/images.html Property of MN Department of Health/DeJong16

17. Image used with permission from http://wicworks.nal.usda.gov/wicworks/resources/images.html Property of MN Department of Health/DeJong17 Resource & Referral system. Child care providers play an important role in supporting employed, breastfeeding mothers. Child care regulations first appeared on The Breastfeeding Report Card in 2010. States that received optimal scores were those whose regulations fully comply with national standards regarding breastfeeding, including making arrangements for a mother to be able to feed her child on-site.

18.  Found at http://www.healthykidshealthyfuture.org/startearly/th egoal.html http://www.healthykidshealthyfuture.org/startearly/th egoal.html ◦ 1. Physical Activity: Provide 1-2 hours of physical activity throughout the day, including outside play when possible. ◦ 2. Screen Time: None under age 2. For 2 and up, work to limit to 30 minutes/week during child care. Aim for no more than 1- 2 hours/day of quality screen time at home. ◦ 3. Food: Try to serve fruits or vegetables at every meal. Eat meals family-style whenever possible. Avoid serving fried foods. ◦ 4. Beverages: When you can, give water during meals and all day. Avoid sugary drinks. Two and up, serve low- or non-fat milk and 4-6 ounces max of 100% juice a day. ◦ 5. Infant Feeding: Provide breast milk to infants of mothers who wish to breastfeed. Welcome mothers to nurse mid-day and support parents’ decision with infant feeding. Property of MN Department of Health/DeJong18

19.  Here is an example of how the MN Childcare Resource and Referral is supporting breastfeeding education for childcare centers. The course is described as follows: ◦ This online course will introduce the importance of breastfeeding to children, mothers, and child care programs. Topics will include benefits of breastfeeding, risks of not breastfeeding, breastfeeding guidelines, and safe handling and storage of breast milk. ◦ Participants will identify ways for child care providers to support breastfeeding families. Participants will also learn strategies to improve breastfeeding promotion and support in both home and center-based child care settings.  CDA Content Area 1; Core Competency Area VI;  Meets Parent Aware Training Requirement  Chat Sessions: Tuesdays from 7:00-7:45 p.m. CST.  Cost: 60.00; credit for 12 hours of training  To register go to www.eagertolearn.orgwww.eagertolearn.org Property of MN Department of Health/DeJong19

20. In Goldade et al.’s (2008) longitudinal qualitative study of 44 low-income, smoking women in the U.S., an issue reported by more than three-fourths of the sample (79%) was the stigma of breastfeeding in public. Results showed that despite 36 (82%) of respondents stating that they intended to breastfeed for an average of eight months, rates of initiation and duration were much lower than intentions. By six months postpartum, only two women were breastfeeding exclusively. Authors noted that low-income mothers spent a lot of time in public places, such as healthcare offices, on public transportation, and in grocery stores that they frequented often to buy small purchases that they could carry home without the use of a car. Property of MN Department of Health/DeJong20

21.  In McCann et al.’s (2007) WIC Infant Feeding Practices Study, which was a one-year longitudinal national study of WIC participants, 61% of mothers reported concern about not wanting to breastfeed in public. One reason for this response from lactating mothers may be reflected by the national HealthStyles surveys conducted in 1999 and 2003, where one-third of the general population agreed that “mothers who breastfeed should do so in private places only,” and just under half agreed that “I am comfortable when mothers breastfeed their babies near me in a public place, such as a shopping center, bus station, etc.” Property of MN Department of Health/DeJong21

22. Across The Globe, Men And Women Are Staging Protests In Order To Get Facebook To Change Its Policies Against Images Of Breastfeeding. http://www.youtube.com/watch?v=HIDjgiNOav0&f eature=related http://www.youtube.com/watch?v=m3NkJSRlWwg Property of MN Department of Health/DeJong22

23.  Military Moms Breastfeed  Article at http://shine.yahoo.com/parenting/military- moms-breastfeeding-uniform-stir- controversey- 214500503.html;_ylt=Ao5EGKXF5LfHQ3TNlXI txbGWJvJ_;_ylg=X3oDMTFiMjR1MWs4BHBzdG FpZAMyNGU4ZmViMC00ZTQxLTMzNGUtOTY5 YS01Yzk4Y2E5ZmE2YjE-;_ylv=3 http://shine.yahoo.com/parenting/military- moms-breastfeeding-uniform-stir- controversey- 214500503.html;_ylt=Ao5EGKXF5LfHQ3TNlXI txbGWJvJ_;_ylg=X3oDMTFiMjR1MWs4BHBzdG FpZAMyNGU4ZmViMC00ZTQxLTMzNGUtOTY5 YS01Yzk4Y2E5ZmE2YjE-;_ylv=3 Property of MN Department of Health/DeJong23

24.  In 2009, Fairbrother and Stanger-Ross reported their findings of an experimental design that assessed the knowledge, attitudes, and infant feeding intentions of Canadian, female undergraduate students (n = 285). Surveys were randomly distributed to students. One version contained a snapshot of a woman breastfeeding an infant (n = 131) and the other a woman bottle feeding (n = 154). Property of MN Department of Health/DeJong24

25.  Although findings indicated that the majority of the respondents had themselves been breastfed (84%) and they intended to breastfeed their own infants (97%), and that participants reported more positive attitudes toward the photographs of the breastfeeding woman when compared to the bottle feeding visual depiction, they expressed less positive views of the woman who breastfed in public compared with the woman who bottle fed in public.  So, I ask: How has this education changed you?  If you were in the study above, how would you react today, following this training? Property of MN Department of Health/DeJong25

26.  Before you leave today, take a moment to write a 1-minute reflection of what you’ve learned.  What is your Take-Home? Property of MN Department of Health/DeJong26

27. End of:  Objectives 17: Providing support in a variety of settings  Objectives 18: Impact of public health  Objectives 19: Evaluation of own community – discuss ways to support breastfeeding where student works and lives Next:  References Property of MN Department of Health/DeJong27