North Carolina Breastfeeding Coalition
Minutes of the Meeting on March 17, 2007
Attending:
La Leche League (LLL)
La Leche League (LLL) and Wayne County Breastfeeding Resource Team
Tri-County Breastfeeding Coalition
NorthEast Medical Center in Concord
(Cabarrus County)
UNC Center for Infant and Young Child Feeding and Care
Family Care of Durham, NC, and Nursing Mothers of Raleigh (NMR)
WakeMed Health & Hospitals and Triangle Breastfeeding Alliance
(TBA)
NC Association of Local Nutrition Directors (NCALND)
NC Pediatric Society
Gaston Memorial Hospital Breastfeeding Coalition
NC Division of Public Health
Rex Healthcare
La Leche League of NC
UNC Center for Infant and Young Child Feeding and Care
Chairperson Vicki Carlson opened the meeting by welcoming everyone and calling for brief self introductions. We were reminded of our goal:
The mission of the North Carolina Breastfeeding Coalition is to
promote,
protect and support breastfeeding through a cooperative network of
individuals, coalitions, agencies and organizations.
The minutes from the January meeting taken by Marian Kuczero were approved. Mary Overfield volunteered to serve as recording secretary.
Report on a meeting: Discussion of Legislative Action in Support of the NC Blueprint for Promoting, Protecting and Supporting Breastfeeding:
Miriam and Mary Rose provided copies of the minutes of a meeting convened on February 16, 2007, by the UNC Center for Infant and Young Child Feeding and Care. Interested parties met with Action for Children (www.NCchild.org) a private lobbying group funded by the Annie E. Casey Foundation. Three actions resulted from that meeting:
Report on a Summary
of Breastfeeding Survey of Pediatricians conducted by Steven Shore through the
NC Pediatric Society (NCPS):
Steven reminded us that NCBFC members had suggested some of the survey questions, so the answers address concerns of our statewide coalition. The response rate was fairly good compared to similar surveys. It is encouraging to learn that approximately 70% of the pediatricians who responded to the survey indicated an openness to getting more information about current research and breastfeeding management. More details will be available after the survey results are presented to the NCPS.
Report on a US Breastfeeding Committee (USBC) conference phone call among the statewide coalitions: Catherine Sullivan represented NC on the call and announced there is a CD-ROM to come to each state from the CDC and the USBC to report on progress being made. She will make each of us a copy when it arrives. Concern about current child obesity and infant mortality rates is fueling collaboration at the federal level.
Report on the Winston-Salem Coalition: Vicki announced that the coalition has disbanded and that they donated $150 to NCBFC to use needed.
Report on NCBFC
Accomplishments:
Strategic Planning:
Resources -
Each attendee received a resource packet that Vicki had compiled, including copies of:
Ø “Ban The Bags” in North Carolina
Ø Baby Friendly North Carolina Model Hospital Policies
Ø North Carolina Breastfeeding Report Card (Massachusetts model is “The MBC Nurse Manager Survey of Breastfeeding Practices”)
Ø State structure for breastfeeding support (NC model is Perinatal Regions/County Coalition Development)
Ø Workplace support in NC
Ø Daycare support in NC
Ø Social marketing campaign for NC
Ø Political issues
Setting Priorities
-
Our Chairperson suggested that each person speak for no more than 3 minutes to suggest two top priorities for the NCBFC for the next 2 years.
Vicki: 1. Completing the structure of our statewide coalition and forming specific
committees to address issues: Information and Data, Public Awareness,
Education and Training, Policy and Advocacy and Outreach. The by-laws
will need to be redrawn to reflect this new structure.
2. Developing a state structure for support - many good models already exist
that could help us achieve a goal: 50 counties with BF coalitions by the end of
2009. NCBFC could develop and facilitate this with contacts, workshops
and information packet development.
Phyllis: Widening the variety of individuals from various backgrounds serving on the
NCBFC to enable our coalition to serve as an effective problem-solving group.
Elaina: Involving more physicians. She contacted Michelle Jones, the new President of the
NC Academy of Family Physicians (NCAFP), after attending a 4-day NCAFP
conference in Asheville during which there was NO mention of breastfeeding at all!
In her letter, Elaina called for the Academy to get involved in the NCBFC and
support the NC Blueprint for Action on Breastfeeding.
Sheri: Completing the Resource Guide for every county, not only for the referrals for
breastfeeding families, but also for turning each of the identified resources into
contact points for working with the NCBFC.
Mary: Working with the people with the power to make changes by legislation.
Catherine: Collaborating with other groups. She is working with the NC Dietetic
Association (NCDA) to encourage them to see that they have an ethical
responsibility to focus on the welfare of children. She is working with the NCDA
Board of to support the NC Blueprint. She is urging that for one out of every 5
years their emphasis will be on a breastfeeding topic.
Steve: Working with Dr. Sanion (Spelling?) and others through the NC Pediatric Society to
make North Carolina Baby and Breastfeeding Friendly.
Mary Rose: Working with the NC Perinatal Association to “Ban the Bags” – if politically
feasible – and to get Baby-Friendly principles into hospital practices. She
handed out Fact Sheet On Formula Marketing in Hospitals which contains
specific action steps. Mary Rose commented that 85% of women come into our
hospitals intending to breastfeed, yet far fewer do as they leave with advertising
samples of formula. Banning the Bags does not take away a mother’s choice, it
means we inform mothers of the facts and our actions match our words.
Mary Rose has been contacted by individuals interested in joining NCBC who are
employed by companies that produce breastfeeding-related products. We agreed
that they may join, but only as interested individuals, and not to represent their
company or products.
******* UNC Hospital
system is applying for “Baby Friendly” designation! *******
Miriam: Working toward “Baby Friendly” status via a different designation – perhaps
“Mother-Baby Friendly” with evaluations conducted by North Carolinians.
There is a School of Public Health graduate student who can work with the NCBFC
pro bono. It has been suggested that to reach the younger generation, we need to
consider using YouTube.
Comments from Laura: We need to educate nurses and new mothers so they won’t have the expectation of freebies – instead of “gifts” they need to see formula bags as advertising. Similar education might help physicians see the commercial nature of the current state of affairs and stop allowing drug company representatives to stock their offices with formula. She also pointed out that working with the NC Child Fatality Task Force to adopt the NC Blueprint will serve our purposes well – there will be open meetings that we can attend and they will find sponsors for new legislation.
Laura: Normalizing breastfeeding via ongoing TV/print campaigns and obtaining peer
counseling programs for areas without them. Comment from Catherine: There are 23
counties currently with the WIC Peer Counselor Programs.
Pam: Working with the WIC Program so it is perceived as a Breastfeeding Resource NOT
a Formula Feeding Resource and increasing diversity of NCBFC so we can support
local coalitions to see themselves as parts of a greater whole. We have a long way to
go in our state when you consider there are pediatric practices that actually put up
signs telling new mothers not to breastfeed in their waiting rooms!
Martha: Getting breastfeeding education to public school children
Victoria: Working to support the Ten Steps for Breastfeeding
Carrol: Having a large breastfeeding conference sponsored by NCBFC
Discussion on
Priorities:
Statewide Coalition
Structure -
§ There are people in even the most rural areas working with breastfeeding families. We can connect with them so they see themselves as part of our statewide effort.
§ Catherine will send a map of the six perinatal public health regions to Sheri to use in compiling the NCBFC Resource Guide.
§ Catherine brought mailing labels to help us reach the NOETS and POETS (Neonatal Outreach Education Trainers/Perinatal Outreach Education Trainers) statewide.
§ We need to remember that the lists for these six regions do not include private practice physicians’ offices; however, in each area one person (such as a neonatologist) would know about local practices.
§
Once the resource people in each county are identified,
we will have not only a statewide network for carrying out the work of the
NCBFC, but also a more complete Resource Guide, and current communication links
identified for legislative work.
Mother-Baby Friendly
-
§ The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) uses ILCA’s Clinical Evidence for the Establishment of Exclusive Breastfeeding as a template for their guidelines for hospital evaluation. This is powerful endorsement because accreditation is required for federal reimbursement. Could they use Baby Friendly Hospital Initiative Guidelines in a similar fashion? (Jan Barger is our current ILCA representative to JCAHO.)
§ The cost of giving up “free” formula may be of great concern; however, the cost of formula needs to be calculated on the basis of what is actually used, not on what is (over)supplied by the formula companies.
§ Regardless of costs, there is a moral imperative and a corporate responsibility that hospitals not advertise to a patient in a vulnerable position.
§ Because the NC Blueprint calls for our hospitals to achieve Baby-Friendly status, we could decide to conduct our own evaluations as “Mother-Baby Friendly - North Carolina” “Breastfeeding-Friendly” or some other moniker, to avoid paying fees and expenses for the existing non-governmental organization (NGO) US Baby Friendly. Texas and New York have already done so successfully.
On-going Social
Marketing -
§ Stay positive! Professional ethics and a best practice approach will appeal to colleagues.
§ Formula needs to be viewed in the same way as second hand smoke is now viewed.
§ There will be incremental progress – building on previous successes will empower women.
Miriam Labbok observed that there are three “engines” that can help drive NCBFC success:
1. Hospitals (with the largest number of IBCLCs to push for Mother-Baby Friendly status)
2. Governmental leadership (through agencies and policies)
3. Community opinion (as the importance of breastfeeding becomes shared knowledge)
Consensus on Three
Priorities:
1. Achieving “Mother-Baby Friendly” status to affect our hospitals
2. Completing the structure of our statewide coalition to affect our government agencies
3. Conducting on-going social marketing to affect our communities
Formulating Goals:
Many of us liked Goal 2 on page 4 of the San Diego Strategic Plan:
Ensure
that breastfeeding is recognized as the normal method of infant and young child
feeding and is woven back into our parenting and general societal culture.
Miriam cautioned us against abbreviating the process of developing our own unique NC plan. She suggested that we plan a retreat to focus on issues specific to our state. While 72% of mothers initiate breastfeeding in NC, the total breastfeeding picture in NC is far from ideal.
Proposed Goal (or
Vision):
Ensure that early, exclusive and
continued breastfeeding will be the norm in North Carolina.
Suggestion for a T-shirt:
(On the front:)
“Do you know the norm?”
(On the back:)
Early, exclusive and continued breastfeeding
is the norm in North Carolina.
In order to create an
effective strategic plan, we need to articulate our strengths, opportunities,
weaknesses, and threats.
Strengths:
(See the SC Breastfeeding Action Committee website: www.SCBAC.org
Ø MidSouth Lactation Consultant Association
Ø State WIC Program (NC WIC State Breastfeeding Coordinator is a member)
Ø NC Pediatric Society (Executive Director works with the coalition)
Ø UNC Center for the Feeding and Care of the Infant and Young Child
Ø Nursing Mothers of Raleigh
Ø La Leche League
Ø People with political clout
So, we have
enthusiasm and commitment from people with depth and breadth of experiences, as
a result – LONG TERM VISION
Opportunities:
Ø Infant morbidity, especially SIDS
Ø Childhood obesity
Ø Spent $1.7 million on breastfeeding in 2006
Ø Adding a position for a WIC Breastfeeding Peer Counselor Program Coordinator
Weaknesses:
Ø Saturday meetings
Ø Separate meetings for MidSouth LCA and NCBFC
Threats:
In order to create an effective strategic plan, we need to have objectives that are specific, measurable steps to help us achieve our vision and our mission. (SMART+C = Specific, Measurable, Achievable, Relevant to our mission, Timed and Challenging.)
Objective 1: Create a sustainable structure for
NCBFC within 2 years, evidenced by:
§
Increased
diversity
§
Designated chain
of communication contact person in all 6 perinatal regions
§
501 (c) 3 tax
status
§
Dissemination of
website information across the state
Possible Strategies:
Use USBC structure as a template with an Executive Committee of
Officers and Committee Chairs
Possible Standing Committees:
§ Statewide Structure for Breastfeeding Support
§ Executive or Governance (draft by-laws)
§ Baby-Friendly Hospital Initiative or “Mother-Baby Friendly North Carolina”
§ Social Marketing of Breastfeeding
§ Outreach and Expansion
Objective 2: Create a “Mother-Baby Friendly” health care system in North
Carolina as defined by ? % of babies born in birthing settings that meet the
designation criteria by ___ years (Recommendation #2 in NC Blueprint)
Objective 3: Involve media, use social marketing and public education to
promote breastfeeding within 2 years
(Recommendation #6 in NC Blueprint)
Objective 4: Establish a statewide structure for breastfeeding support as
evidenced by each county having an active local contact for the NCBFC within 2
years
Objective 5: Create a Committee for Outreach and Expansion of Diversity within
1 year
Possible Strategies:
Invite insurance company representatives
(BeeBee from
Blue Cross/Blue Shield of NC)
Involve companies with corporate
breastfeeding support
programs (Nancy Register from SAS)
Have an evening dinner meeting at the
regional Art of
Breastfeeding Conference on Tuesday, October 9th to attract
interested parties who might be among the 275 + people attending the conference
Coordinate a few NCBFC and MidSouth LCA meetings each year to increase
attendance in both groups
NC Pediatric
Society:
Lunch Provided –
The NC Pediatric Society was kind in providing attendees with box lunches. Thank you to Steve for initiating and organizing our lunches.
Bank Account for
Coalition -
We voted to accept Steve’s offer to create a dedicated account within the NC Pediatric Society checking account in order to allow NCBFC to accept donations and be able to give tax deductible receipts. He can offer this with the understanding that the NCBFC will work toward attaining 501(c)3 status. It will cost approximately $1,500, so we need to accumulate some funds. We appreciate having a way to handle funds appropriately as we get established.
World
Breastfeeding Week:
The theme for 2007World Breastfeeding Week is “Initiate Within the First Hour.” The NC Governor no longer issues proclamations about such celebrations, but we could do our own.
Two possible dates:
The first week in August: the 1st -7th OR - if vacations make that difficult,
The fortieth week of the year: September 30th – October 6th
Upcoming
Conferences:
§ The Fifth Annual Triangle Breastfeeding Alliance Conference will be held at the Andrews Center at WakeMed on Wednesday, May 9th. See a brochure and register on-line at www.WakeAHEC.org Contact Elaina or Mary for more information.
§ Miriam announced the Feminism, Breastfeeding and Reproductive Rights Conference will be held at UNC-Chapel Hill this year on September 24, 2007. Contact Miriam for details.
Next Meeting:
The next NCBFC meeting will be on Saturday, May 19, 2007, from 10:00 AM to 2:00 PM in the same location as the March 17th meeting - on the ground floor in Room G 35 at the Wake County Division of Human Services, 10 Sunnybrook Road, Raleigh, NC 27610.
Please come prepared to continue working on our strategic plan, volunteer to serve on a committee and to discuss the idea of a retreat.
Respectfully submitted,
Mary Overfield
NCBFC Recording Secretary