Business Case for Breastfeeding

1. Business Case for Breastfeeding Jaclyn Santana Colleen Wickham Katharine Sali Betty McLaughlin Ashley Deal Nicole Velazquez Alexandra Albarran

2. Business Case for Breastfeeding • Government action plan • Educate employers on the importance of supporting breastfeeding in the work place • Offers tools to business managers to promote breastfeeding employees

3. Business Case for Breastfeeding • Agency Contact: Krista Schoen • Florida Department of Health • Provided us with a list of day care centers in Osceola, Orange, Seminole, and Palm Beach county.

4. Goals Identify common barriers: 1. Inconvenience 2. Knowledge Deficit 3. Unavailable Equipment 4. Finances 5. Liability 6. Medical conditions (i.e. mother cannot breast feed for whatever reason)

5. Benefits to Baby • Breast milk provides necessary nutrients and antibodies to strengthen the immune system and protect against disease. • Decreased incidence of ear infections, upper and lower respiratory infections, and diarrhea, which are all common in daycare facilities. (AWHONN, 2012). • Some research supports that breastfeeding can also reduce the risk of Type 1 diabetes, childhood leukemia, and atopic dermatitis. • Breast milk is easier than formula to digest (US Department of Health and Human Services,2010).

6. Benefits to Mommy • Decreased risk of postpartum depression, Type II diabetes,osteoporosis, hip fractures, ovarian and breast cancer. • Mothers also report stronger bond when they breastfeed their baby. • Decreased expense: Formula and feeding supplies can cost well over $1,500 each year, depending on how much your baby eats. Breastfed babies are also sick less often, which can lower health care costs. • (AWHONN, 2012).

7. Benefits to Society • Recent research shows that if 90% of families breastfed exclusively for 6 months, almost 1,000 infant deaths could be prevented. • The United States would save $13 billion per year due to lower medical care costs for fully breastfed infants than never-breastfed infants. Breastfed infants typically need fewer sick care visits, prescriptions, and hospitalizations. • Mothers miss less work to care for sick infants, which contributes to a more productive workforce. Employer medical costs are also lower. • Breastfeeding is also better for the environment. Less trash and plastic waste are produced compared to that by formula cans and bottle supplies. • (U.S. Department of Human Health Services, 2010)

8. Barriers to Breastfeeding • Lack of confidence • Embarrassment/societal norms • Medical conditions/medications • Lack of knowledge • Poor family and social support • Lactation problems • Employment and child care

9. Project Barriers • No infants or lack of infants • Availability of supplies and storage • Space for breastfeeding • Contacting daycares

10. Breastfeeding Facilitators • Space for breastfeeding • Refrigerators/freezers for the storage of labeled breast milk • Proper preparation, handling, and storage of breast milk • Breastfeeding policies • Family support

11. Why is Project Needed? • The World Health Organization, American Academy of Pediatrics, and many other organizations recommend that an infant be breastfed for at least one year, with the first 6 months exclusive to breastfeeding. • Breastfeeding is most essential to the infant, but is also beneficial to the mother (AWHONN, 2012). • This project serves to increase awareness and empower mothers to breastfeed their infants in day care centers.

12. Future Role as an NP • We have learned the importance of breastfeeding and we can now apply this knowledge and educate our patients. • Learning the barriers to breastfeeding has given us the knowledge to anticipate these barriers for our patients and how to work around them. • We have also learned about the resources available and as NPs we will know where to direct our patients to receive these resources.

13. Follow Up Seminole County • 5 daycare centers in Seminole County were visited and provided with the previous pamphlet. • The daycares were called and asked if the pamphlets were beneficial and if they had any impact on the breastfeeding policies at the facilities. • 1 facility handed out the pamphlets to new and expecting mothers so that they would know how to handle their own breast milk at home. • Another facility posted the guidelines by the refrigerator in their facility. • The other 3 facilities did not do anything with the pamphlets due to already having breastfeeding policies in place.

14. Breastfeeding Storage Pamphlet distributed in Seminole County • Storage • Make sure the container is clearly labeled with the child’s name and the date. • Store milk in the back of the refrigerator where the temperature is most constant. • Milk stored in the refrigerator at 37F or 4C is good for 5 days. • Milk left on a countertop at room temperature is good for 6-8 hours and should be kept covered. • DO NOT save milk from used bottle for another feeding. • Preparation • DO NOT microwave breast milk (due to uneven heating and damage to the milk). • Instead thaw frozen breast milk in the refrigerator or swirl in a bowl of warm water. • Handling • Wash your hands prior to handling breast milk. • Source: CDC and American Academy of Pediatrics

15. Follow up Palm BeachCounty • Information was given to three day care centers regarding the Proper • Handling and Storage of Breast Milk • Make sure milk container is clearly labeled with the child's name, date and • the date the milk was expressed (To facilitate using the oldest milk first). • Do not add fresh milk to an already existing storage container. • Do not save milk from a used bottle for another feeding. • Safely Thawing Breast Milk • As time permits, thaw frozen breast milk by transferring it to the refrigerator • for thawing or by swirling it in a bowl of warm water. • Avoid using a microwave oven to thaw or heat bottles of breast milk • Microwave ovens do not heat liquids evenly and could scald the infant • Bottles may explode if left in the microwave too long. • Excess heat can destroy the nutrient quality of the expressed milk. • Do not re-freeze breast milk once it has been thawed.

16. Follow up: Palm Beach CountyStorage Duration of Fresh Human Milk for Use with Healthy Full Term Infants

17. Follow Up Osceola and Orange Counties • No facilities currently had any infants, wherein breastfeeding policies could be implemented. • Infants were expected in the upcoming months for a few centers, however, this project would already be complete.

18. References • Benjamin, S., Taveras, E., Cradock, A., Walker, E., Slining, M. and Gillman, M. (2009). State and regional variation in regulations related to feeding infants in child care. Pediatrics, 124(1), 104-111. doi: 10.1542/peds.2008-3668 • Brenner, M. G., &Buescher, E. S. (2011). Breastfeeding: A clinical imperative. Journal of Women's Health, 20(12), 1767-1773. • Brodribb, W. E. (2012). Breastfeeding- A framework for educating the primary care medical workforce. Breastfeeding Review, 20(2), 25-30.        • Brown, A., Raynor, P., & Lee, M. (2011). Healthcare professionals' and mothers' perceptions of  factors that influence decisions to breastfeed or formula feed infants: A comparative study. Journal of Advanced Nursing, 67(9), 1993-2003. • Brown, A., Raynor, P, & Lee, M. (2011). Young mothers who choose to breast feed: the importance of being part of a supportive breast-feeding community. Midwifery, 27, 53-59.  • Centers for Disease Control and Prevention (2012). Breast feeding report card-United States 2012. Retrieved from http://www.cdc.gov/breastfeeding/pdf/2012BreastfeedingReportCard.pdf • Chen, P. G., Johnson, L. W., & Rosenthal, M. S. (2012). Sources of education about  breastfeeding and  breast pump use: What effect do they have on breastfeeding duration? An analysis of the infant feeding practices survey II. Maternal Child Health Journal, 16, 1412-1430. • Association of Women’s Health, Obstetric, and Neonatal Nurses. (2012). Working and Breastfeeding Helping Moms and Employers Figure It Out. Retrieved from http://www.awhonn.org/awhonn/content.do ?name=02_PracticeResources/2C1_Breastfeeding.htm • Clark, A., Anderson, J., Adams, E., Baker, S. (2008). Assessing the knowledge, attitudes, behaviors and training needs related to infant feeding, specifically breast feeding, of child care providers. Maternal Child Health, 12, 128-135. doi: 10.1007/s10995-007-0221-4 • Gildea, A., Sloan, S., Stewert, M. (2009). Sources of feeding advice in the first year of life: who do parents value? Community Practitioner, 82(3), 27-31. • Hawkins, S., Griffiths, L., Dezateaux, C., Law, C., & the Millenium Cohort Child Study Health Group (2007). The impact of maternal employment on breast-feeding duration in the UK millennium cohort study. Public Health Nutrition, 10(9), 891-896. doi: 10.1017/S1368980007226096

19. References • Javanparast, S., Newman, L., Sweet, L. and McIntyre, E. (2012). Analysis of breastfeeding policies and practices in childcare centers in Adelaide, South Austraila. Maternal Child Health, 16, 1276-1283. doi: 10.1007/s10995-011-0887-5 • Lantera, S., Polkki, T., &Pietila, A. M. (2011). A descriptive qualitative review of the barriers relating to breast-feeding counseling. International Journal of Nursing Practice, 17, 72-84. • Manhire, K., Horrocks, G., Tangiora, A. (2012). Breastfeeding knowledge and education needs of early childhood centre staff. Community Practitioner, 85(9), 30-33. • Marsden, A., &Abayomi, J. (2012). Attitudes of employees working in public places toward breastfeeding. British Journal of Midwifery, 20(4), 271-277. • O’Conner, M. (1998). Breastfeeding benefits and barriers. Retrieved from http://www.breastfeedingbasics.org/cgi-bin/deliver.cgi/content/Introduction/ • Office of the Surgeon General. (2011). Barriers to Breastfeeding in the United States. Available from: http://www.ncbi.nlm.nih.gov/books/NBK52688/ • Pechlivani, F., &Vivilaki, V. (2012). Breastfeeding and breast cancer. Health Science Journal, 6(4), 610-617.Rempel, L. A., & Moore, K. C. (2012). Peer-led prenatal breast-feeding education: A viable alternative to nurse-led education. Midwifery, 28, 73-79. • US Department of Health and Human Services. (2010). Breastfeeding: Why breastfeeding is Important. Retrieved from http://www.womenshealth.gov/breastfeeding/why- breastfeeding-is-important/

20. THE END Questions????