New Food

Choices
Support
Breastfeeding
No one can make you feel inferior without your
consent.
Eleanor Roosevelt

New Food Choices will bring changes to the

way we support breastfeeding moms
Today we will:
Learn about the new
breastfeeding policies
Identify two key points
behind the rationale of
not issuing formula in
the first month of life
Become familiar with
the term Anticipatory
Guidance

New Food Choices will bring changes to the

way we support breastfeeding moms
Learn the steps of a Breastfeeding Review
Locate three key breastfeeding
resources available to you during a
Breastfeeding Review

Policy Changes
Formula will no longer be
routinely issued to
breastfeeding babies
All breastfeeding moms &
babies will receive a full
Breastfeeding Review before
receiving any formula
The Breastfeeding Review
shall be documented in the
Notes section in the client
record

Policy changes
Breastfeeding moms with infants over 6 months of age
receiving more than the amount of formula in an infant
formula food package:
Will no longer receive food for themselves
Will be counted as participating on the WIC program as
breastfeeding women
Will be given support and education
to continue breastfeeding

Time for a change

Thinking about how WIC supports breastfeeding, what have
you learned about New Food Choices changes that surprises
you?

Sally Blizzard Yakima Neighborhood Health Services

Why no infant formula in the first month

The breasts make milk in response to three factors:
Hormones
Stimulation
Milk being removed from
the breast

breast milk!

Breastfeeding makes

Why no infant formula in the first month

These common practices can cause moms to lose their
confidence and quit breastfeeding early:
Formula samples given by medical providers
Formula supplementation in the hospital
Formula samples and coupons given in discharge bags
Formula checks issued at WIC just in case

Breastfeed - right from the start!

Provide pregnant moms
information on:
What to do in the hospital
to start nursing off right
Normal breastfeeding
What to expect as baby
grows

This is called
Anticipatory
Guidance

An overview of the Breastfeeding Review

A Breastfeeding Review is an
assessment of how breastfeeding is
going

It must be completed anytime a

breastfeeding mom is
requesting
formula, or asks for an
increase in
the amount of formula
she
already receives from WIC

The purpose of the review is to

address
concerns and help find
solutions that enable continued
breastfeeding, and
to minimize/delay
the use of formula
10

Who can do a Breastfeeding Review and issue

Only Competent Professional Authorities (CPAs and
formula
checks to breastfeeding infants?
nutritionists) trained in breastfeeding support may do a
Breastfeeding Review

11

Where a Breastfeeding Review starts

12

A walkthrough of a Breastfeeding Review

1. Establish rapport with the client by introducing
yourself Hello April. My name is Martha.
2. Tell the client the reason for the discussion
I understand you have some breastfeeding
concerns.

13

A walkthrough of a Breastfeeding Review

3. Show respect for the client and engage her in
discussion about how she is feeding her baby and
what her plans are
Most new mothers have questions about feeding
their baby.
4. Use open-ended questions and active listening skills
to find out why the client is requesting formula
Tell me why you think your baby needs formula
today.

14

A walkthrough of a Breastfeeding Review

5. Affirm the clients feelings or concerns and engage
the client in the discussion while offering support
and encouraging continued breastfeeding
Being a new mom is exhausting. The first few
weeks can be challenging. Lets figure out a plan so
you can continue to breastfeed. Its going to get
easier!
6. Allow the client to share thoughts and try to avoid
dominating the conversation
Tell me more about that.
What have you tried that seems to makes
breastfeeding work better for you and your
baby?
15

A walkthrough of a Breastfeeding Review

7. Target education to the clients needs and avoid
providing unneeded information
It sounds like you want some help in figuring out
how deal with your sore nipples. I have information I
can share with you. Would you like to hear more?
9. Discuss the information in any handouts provided
On page 35 of this booklet Ill give you is a list of
things we discussed about dealing with sore nipples.
I placed a bookmark so you can go back for a quick
review.

16

A walkthrough of a Breastfeeding Review

10. Ask for the clients feedback on the
usefulness of the
information
What information was useful for you?
What other questions do you have?

17

What would this scenario look like in our

clinic?

18

The Breastfeeding Review: Scenario

1
Maria

19

The Breastfeeding Review: Scenario 2

Lisa

20

The Breastfeeding Review : Scenario 3

Anna

21

When formula is Issued to a breastfeeding

baby
CPA shall educate and
counsel the mother that
adding formula to her
babys diet will have a
negative effect on her
breast milk production
and may end
breastfeeding.

22

What if there is no CPA available to do a

Breastfeeding Review?
Affirm the moms concerns and explain that staff who can
determine the food package are not available
Encourage her to keep breastfeeding and inform her that
giving formula may decrease her ability to make milk
Offer support within your skill level
Schedule as soon as possible with a CPA who can do a
BFR or refer to community resources to do a BFR, if
available
Offer to have someone
contact her by phone
Suggest resources for formula

23

Our clinics breastfeeding resources

Its not just one persons responsibility to do breastfeeding
Its everyones responsibility
Share your favorite breastfeeding resource with your team

The La Clinica Team

24

What you can do to learn more about

breastfeeding
Attend regional WIC breastfeeding trainings
Read books in the clinic
The LLL Answer Book,
Amy Spanglers book, Breastfeeding Keep it
Simple
Other books
Read and study the WIC client handouts
Visit http://www.doh.wa.gov/cfh/WIC/breastfeeding.htm
Review self study materials
Complete online courses

25

One more look at the Breastfeeding Review

A Breastfeeding Review is an assessment of how
breastfeeding is going.
A Breastfeeding Review must be completed before any
formula is issued to a breastfeeding baby, or when the
amount of formula is increased.
It may also happen whenever a breastfeeding mom has
questions, whether she is requesting infant formula or
not.
The purpose of the review is to address concerns and
help find solutions that enable her to continue to
breastfeed, and to minimize/delay the use of formula.
Our goal is to help moms successfully breastfeed!
26

Closing

27

DOH 960-113 August 2009

For persons with disabilities this publication is available

on
request in other formats. To submit a request, please
call 1-800-841-1410.
28