Developing and Sustaining Breastfeeding Peer Support Programs

1. Developing and Sustaining Breastfeeding Peer Support Programs By Michelle Buckner

2. In this session you will learn about: PEER BREASTFEEDING SUPPORT !!!! • Recruiting and sustaining a strong volunteer base • The importance of comprehensive peer training • What types of services peer breastfeeding volunteers can offer • Collaborating with and engaging community partners for ongoing program support and success

3. Recruiting volunteers How do your programs recruit volunteers?

4. Recruiting volunteers • Identify breastfeeding moms who are community leaders (playgroups, LLL meetings, midwifery clinics etc.) as potential volunteers and program participants • Ask professionals who work with moms to identify “breastfeeding champions” in community • Ask for moms contact information, especially with priority populations as they may not have resources or confidence to follow up • Invite moms to attend working groups or BFI committee meetings. (increase moms ability to participate by reducing barriers i.e. providing childcare, snacks etc.) • Use existing social mediato recruit volunteers and promote peer breastfeeding program • Advertise where moms hang out i.e. OEYC, malls, community centres • Word of mouth is VERY important for recruitment

5. Moms recruiting Moms…… “ I wanted to support other moms by sharing my breastfeeding challenges and triumphs. Now the women I have helped want to reach out to new mothers too.” Breastfeeding Buddy 2013

6. Other recruitment tips…. • Develop a “job description” clearly outlining qualifications, the role of a peer breastfeeding volunteer and training provided • Compile an application package that is available via mail or email with a set deadline • Conduct interviews- places importance on the role, allows you to gather more information on moms and to share details of program/training • Present the program as an important service for the community that will attract passionate and dedicated volunteers.

7. Retaining volunteers What is the average length of time a volunteer participates in your program?

8. Volunteerism….. “Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” ~Leo Buscaglia

9. Retaining Volunteers.... • Placing value on their time and lived experience by: • Providing a meaningful volunteer experience with opportunities to give feedback on future direction of program i.e. sitting on advisory committee • Offer a variety of roles for them to practice existing breastfeeding support skills and to develop new skills i.e. telephone help, group facilitation, presentations • Find out about other skills and delegate tasks to them • Honor their contributions to the program as useful and necessary by sharing breastfeeding stats and evaluation feedback

10. Retain volunteers bycreating a peer breastfeeding culture! • Host regular staff meetings that: • provide extended learning opportunities • host meetings in familiar, safe spaces • promote mentoring, role playing and resource sharing • increase a sense of community • address scope of practice for the peer • Provide access to a peer coordinator who can: • answer questions and offer support • oversee program while creating a strong team approach • send regular emails with links, program updates and messages of appreciation to increase engagement • offer “mom sized” volunteer opportunities • use social media i.e. Facebook to create forum for sharing

11. …. share, learn , connect and inspire…. “I feel such a strong sense of connectedness with my fellow BFB. I can complain to them, offer ideas, get support and feel like I am part of an important team. I am motivated every time I come to a meeting to continue to offer breastfeeding help to the moms of our region.” BFB 2011

12. The importance of comprehensive peer training What it looks like and why?

13. World Health Organization: “In order to provide appropriate support for breastfeeding mothers, both lay and all health-care professionals need to be trained in all aspects of breastfeeding. This training should include breastfeeding management, nutrition, infant growth and develop­ment, counselling techniques, and criteria for making referrals and it should be tailored to local requirements…”

14. What does comprehensive peer training look like? Training Binder/Resources • 20 hour peer breastfeeding course(Based on the WHO/UNICEF Model) • Co- facilitated by medical professional and peer trainer • Continued training via coordinator at staff meetings • Policy and procedures to guide scope of practice • Course materials, common Q&A, community resources, nutrition and parenting sections • Resource book such as “Bestfeeding” or “The Womanly Art of Breastfeeding”

15. Breastfeeding Buddies Handbook 2013 - 2014 A program supported by Kitchener Downtown Community Health Centre Region of Waterloo Public Health, and other Community Partners

16. Why is it important? • Comprehensive training increases retention rate, and level of commitment from volunteers • Strengthens volunteers knowledge, skills and confidence • Normalizes breastfeeding by placing value on the role of the peer breastfeeding volunteer • Establishes credibility and “buy in “ from medical professionals and community partners • Compliments BFI messaging – Step 10 • Provides consistent breastfeeding information and support for moms in the community.

17. Class of 2012 “Each day I wanted to come earlier. I learned so much and I felt well equipped to help moms…I can’t wait to share this knowledge with others!” BFB 2012

18. Types of services peers can offer Changing breastfeeding culture ….

19. Reclaiming Breastfeeding culture… Peer support normalizes breastfeeding

20. Roles for peer breastfeeding volunteers One to one matches Community site support • Volunteers are matched with a mom based on criteria such as language, breastfeeding experiences and challenges • “significantly more mothers in the peer support group who received telephone support continued to breastfeed at 3 months postpartum compared to the control group who were not matched with a peer volunteer.” C. Dennis, 2002 • Peer volunteers can attend sites to provide face to face breastfeeding support and share community resources • Breastfeeding Cafés, OEYC, playgroups, community centres and events • Providing “incidental” breastfeeding support to all members of the community i.e. school bus stop • Midwife group care breastfeeding workshop

21. Breastfeeding Peer Volunteers can also offer…. Group facilitation & presentations Unique Volunteer Opportunities • Prenatal breastfeeding workshops facilitated by peer breastfeeding volunteers • Prenatal health fair booth attendant • Speaking at events and seminars about peer support • Represent program on committees • “Demo Mom” at peer breastfeeding workshop- nurses her baby and answers participant questions • Encourage them to take program materials to health care providers for future referrals

22. Peer lead prenatal workshop

23. Collaboration & engaging community partners It takes a village……

25. Collaboration How do you get community partners to “buy in” and work together? Where do peer breastfeeding volunteers fit?

26. Invite community partners to peer training, cafes or workshops invite • Demonstrate high level of training peers receive • Emphasize diversity of volunteers • Create networking opportunities between different agencies • Share program evaluations and Data collection to guide future programming • Involve community partners as guest speakers

27. Network by inviting Partners to a Presentation network • Convey research on peer support and breastfeeding success • Emphasize the comprehensive 20 hour WHO training • Showcase programs FREE services and how to access them • Bring peer volunteer to co present information and to speak about scope of practice • Include BFI accreditation guidelines in relation to peer support

28. What does a peer breastfeeding volunteer look like? diversity • experienced breastfeeding moms who are passionate about breastfeeding (minimum 6 months breastfeeding experience • different socio-economic status and education levels • diverse cultural backgrounds • unique family structures • Varying age groups • Compassionate, non-judgemental and knowledgeable

29. Class of 2013 –taking a break while training…

30. Community Partners Who are they? Why should community partners support breastfeeding and the peer model?

31. Midwives and Doulas OEYC Family Outreach La Leche League Baby Shows Health Professionals Public Health NP clinics CHC’s Aboriginal Centres Public Library Parenting Programs Family Health Teams Parenting Youth Groups Municipal Government Hospitals Multi Cultural centre

32. Research … “indicates that breastfeeding peer support programs, in conjunction with professional services are effective…although professional assistance is important, this type of support alone regardless of the quality or quantity, is insufficient to improve breastfeeding outcomes, especially among socially disadvantaged mothers.” C. L. Dennis , University of Toronto, 2002

33. Why should community partners refer to peer breastfeeding support? • Directs normal breastfeeding challenges and questions to women who have lived experience and training • “De medicalizes” breastfeeding • Creates a pathway of diverse breastfeeding support resources for moms; especially those who face barriers to other services i.e teen moms • Empowers women to make informed decisions • Enables medical professionals i.e. lactation consultants to provide necessary specialized medical support for moms and babies while peers address issues of encouragement , support and practical tips • Changes the breastfeeding culture in the community • Addresses step 10 of BFI accreditation and promotes Best Practice Guidelines

34. Breastfeeding Decision Making Factors • Historically women learned “how to breastfeed” by watching other women feed their babies in a community setting; it was part of daily life. • Today, research shows that a women’s choice to breastfeed her baby is strongly influenced by three main factors: PARTNER PEERS HEALTH CARE PROVIDER Dennis C, Hodnett E, Gallop R, Chalmers B. The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial. CMAJ 166:21-28, 2002.

35. BREASTFEEDING AS A DETERMINANT OF HEALTH • Population with the lowest income and education is the group most likely to use ABM. • This population is at the greatest risk for not breastfeeding AND has the most to lose from not breastfeeding both financially and in terms of optimal health outcomes. • Breastfeeding decreases the costs to the healthcare system while providing the best possible free food for children. • A community which supports breastfeeding also supports the optimal health of families regardless of socio-economic or ethno-cultural groups; anyone can breastfeed their baby .

36. Peer Breastfeeding Programs support best practice guidelines World Health Organization UNICEF Canadian Pediatrics Society RNAO Canadian Association of Physicians and Surgeons Dietitians Association of Canada Best Practice guidelines recommend that: “ all babies are exclusively breastfeed for 6 months with the introduction of solid foods in the middle of the first year and to continue to breastfeed for 2 years and beyond” WHO 2012.

37. A normal Breastfeeding Culture is women helping women …….

38. Aim High… …

39. Michelle bucknerBreastfeeding Buddies program coordinator mbuckner@kdchc.org 519 576-7089