Welcome to the State of California 

Information for Professionals: Frequently Asked Questions

MO-07-0050 BFP 

Topics:

  • AAP Breastfeeding Assessment (Word)Opens a new browser window.
  • Breast milk handling in child care centers
  • Contraception
  • Data on Breastfeeding
  • Early Childhood Caries
  • Education for Health Care Providers
  • Emergency Preparedness
  • Hospital Policies and on-line Toolkit to implement them 
  • Medications
  • Mental Health Issues
  • Very Low Birth Weight Infant
  • Vitamin D Information and Resources
  • Work or School
  • What should be considered when a breastfeeding mother needs to have medications? 

    There are many issues to be considered when deciding whether and which medications to use with a breastfeeding mother, including the risk of NOT breastfeeding for both mother and baby. Medications and Breastfeeding

    What information is available for breastfeeding mothers who plan to return to work or school? 

    Many women never consider breastfeeding because they will need to be separated from their babies when they return to work or school.  Health care providers can be instrumental in helping provide anticipatory guidance and support so that women can make the best choice for their families.  Resources to be shared with families, employers and child care workers can be found at: Going Back to Work or School

    How should breast milk be handled in a child care center?

    Breast milk should be handled as all foods for infants and young children:  Appropriate temperature storage, hygiene and labeling to assure each child receives their appropriate food.  For more information go to: Management of Human Milk in Child Care Settings

    What contraceptive options are best for breastfeeding mothers? 

    Some issues to discuss with patients in order to assist them in choosing the best family planning option can be found at: Family Planning and Contraception During Breastfeeding

    How can my community prepare for infant feeding in emergencies? 

    Links to address mother/infant transportation and care, as well as infant and toddler nutrition can be found at: Emergency Preparedness: Infant and Young Child Care and Feeding

    How can I obtain in-hospital breastfeeding rates for a specific hospital or county in California? 

    The California Department of Public Health’s Maternal, Child and Adolescent Health Program provides access to data tables with breastfeeding initiation rates for local hospitals, counties and the State. Link to Hospital Breastfeeding Data.

    What are the Breastfeeding Model Hospital Policy Recommendations and the Toolkit to implement them? 

    These recommendations provide California hospitals with evidence-based actions they can follow which will lead to optimal maternal/infant care. Link to Model Hospital Policies Toolkit.

    What breastfeeding assessments should be done during the infant’s first few visits to meet the recommendations of the American Academy of Pediatrics Policy Statement “Breastfeeding and the Use of Human Milk?” 

    The AAP recommends that infants be seen at days 3-5 and again at 2 – 3 weeks.  The following link is to a sample document (Word)Opens a new browser window.that contains reminders based on the AAP’s document. You can also locate additional information through the American Academy of Pediatrics.

    What evidence-based protocols are available for feeding Very Low Birth Weight Infants? 

    The California Perinatal Quality Care Collaborative has an updated Quality Improvement Toolkit called: Nutritional Support of the VLBW Infant (rev. DECEMBER 2008) with evidence-based recommendations and an appendix that includes resources and sample protocols..

    Does breastfeeding cause Early Childhood Caries (EEC)? 

    Breastfeeding or the age of weaning from breastfeeding have not been proven to increase the risk of early childhood caries. Pediatrics 2007:120;e944-e952. Existing studies implicating breastfeeding as a cause often have not considered other known risk factors in dental caries, such as lack of fluoride exposure, additional dietary sources, or level of a child’s own decay-causing oral bacteria.

    What are the recommendations to prevent rickets in exclusively breastfed infants? 

    The Maternal, Child and Adolescent Health Program sent a letter and attachments on this topic to Public Health providers and programs in June 2007:

  • 2007 Letter to Health Care Providers (PDF)Opens a new browser window.
  • Background Information for 2007 Letter (PDF)Opens a new browser window.
  • FAQs (PDF)Opens a new browser window.
  • What information is available for breastfeeding mothers with mental health issues? 

    Studies have shown that women are more likely to suffer mental health disorders in the early postpartum period.    There are various resources that health care providers and families can use to try to protect the breastfeeding relationship and avoid premature weaning if at all possible.  Supporting Breastfeeding Mothers with Mental Health Issues.

    What courses and programs are available for education of Health Care Providers?

     

    The Academy of Breastfeeding Medicine

  • Policies/protocols (updated regularly)
  • Breastfeeding Medicine - Journal to assist providers in staying up to date with current research
  • Podcasts

  • FREE podcasts are now part of the toolkit that hospitals and physicians can use to stay current with breastfeeding practices thanks to the efforts of Dr. Anne Eglash and the Academy of Breastfeeding Medicine.

    1. As of 7/1/11, the topics include:Neonatal Jaundice and Breastfeeding Part 1 with Larry Gartner MD
    2. The Academy of Breastfeeding Medicine with Jerry Calnen MD
    3. Breastfeeding and the Late Preterm, with Nancy Wight, MD
    4. Establishing a Healthy Milk Supply for Premature Babies with Jane Morton MD
    5. Vitamin D in Breastfeeding, with Carol Wagner MD
    6. The Tight Lingual Frenulum, Or Tongue-Tie, with Evelyn Jain MD
    7. The Non-Latching Infant, with Christina Smilie MD
    8. Donor Human Milk Banking Part 1, with Kathie Marinelli MD
    9. Donor Human Milk Banking Part 2, with Kathie Marinelli MD

    Lactation Education Accreditation and Approval Review Committee (LEAARC) (updated 4/18/12)

  • The American Academy of Pediatrics’ Section on Breastfeeding also has many on-line resources including the following:

  • Breastfeeding Residency Curriculum (2009)
  • Breastfeeding Support and Promotion Speaker's Kit, American Academy of Pediatrics Section on Breastfeeding (2005) (scroll down to the Speaker’s Kit)
  • Breastfeeding Basics: an academic, non-commercial, short course on the fundamentals of breastfeeding. It is geared primarily for the medical practitioner, although anyone is welcome to browse or take the course.

    University of Virginia, School of Medicine, On-Line Learning

  • Breastfeeding Training Course  Free CME Credits provided. Each individual module is designated for 0.5 AMA PRA Category 1 Credit™.

  • The Breastfeeding Friendly Performance Improvement Project is designed to promote quality self-assessment and peer-to-peer interaction, with the ultimate goal of improving patient care.

  • Target Audience: family physicians, pediatricians, and obstetricians/gynecologists.

  • Completion of each phase entitles providers to receive 5 AMA PRA Category 1 CreditsTM. Completion of the full program: eligible to receive 20 AMA PRA Category 1 CreditsTM
  • Mission:

  • empower healthcare providers to increase their knowledge of lactation management;
  • ensure better breastfeeding education for hospital and outpatient staff, patients, and families;
  • improve the quality of care provided to new mothers and babies by implementing nationally defined best-practice strategies related to mother-baby care and infant nutrition;
  • increase the rates of initiation, duration, and exclusivity of breastfeeding;
  • improve the health of mothers and babies;
  • benefit the overall public-health status of the community, state, and nation.
  • Phases:

  • Identify opportunities for performance improvement through a chart review needs assessment.  Care gaps will be used to help formulate a performance improvement (PI) plan.
  • Implement activities in your practice tailored to meet the needs and learning preferences based on the performance improvement plan.
  • Integrate by assessing progress through a second chart review.
  • The Physician Lactation Education Collaborative of Washington State

    Created and tested nine 1-hour lunchtime courses that physicians can present to assure that patients receive consistent and evidence-based information.  The $23.00 CD includes all 9 courses, PowerPoints, pre- and post- tests and instructors’ notes.

    Wellstart International

  • The Lactation Management Curriculum: A Faculty Guide for Schools of Medicine, Nursing and Nutrition (PDF, 4.72 MB)Opens a new browser window
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    Last modified on: 4/18/2012 4:54 PM