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Provide continuum of breastfeeding education
Give moms access to experts after discharge
If women have trouble breastfeeding, they will not continue, says Genevieve Preer, MD, a pediatrician in the Division of Ambulatory Pediatrics at Boston Medical Center (BMC).
While learning the skills is hands-on, with much of the teaching taking place in the hospital with trained staff, it is good to provide support beyond the hospital. Boston Medical Center provides a "warm line" that allows mothers to leave a message and the lactation consultant calls them back.
Also, a lactation consultant is available at the BMC clinics. However, not all women who deliver at the medical center see physicians at the clinics.
Lynn Yonekura, MD, FACOG, director of community benefits for California Hospital Medical Center in Los Angeles, was able to address the lack of continuum of breastfeeding education through another project in which she is involved. In her role as executive director of Los Angeles Best Babies Network, an organization dedicated to achieving healthy pregnancies and births in Los Angeles County, she participated in a quality improvement collaborative involving several prenatal clinics. Using funds from First 5 LA, one person at each clinic was trained as a lactation educator. First 5 LA is a child-advocacy organization created by California voters to invest tobacco tax revenues in programs for improving the lives of children in LA County, from prenatal through age 5. "When the mothers return for well baby checkup at three to five days of life, someone is there to help with questions and issues," says Yonekura.
In addition, nurses at California Hospital Medical Center follow up with a phone call to see how women are doing a couple of days after discharge.
While both medical centers have written materials that their moms can take home to reinforce education and provide information on issues that might arise following discharge, reading materials are not the best choice for the patient population served.
Yonekura says the medical center is cautious in choosing written materials for patients because many are illiterate or read at a third-grade level. "We have designed simpler materials with a lot of pictures," she says.
Providing a support group is another good way to help breastfeeding moms address problems after discharge. The lactation consultant at California Hospital Medical Center runs a postpartum breastfeeding support group. However, not all moms have transportation. Often there is access to peer breastfeeding counselors at local agencies that women can be referred to, such as Women, Infants and Children (WIC). [A feeding tracking sheet and sample flyer on breastfeeding support classes is enclosed with the online issue of Patient Education Management. To access, sign on to your account at www.achmedia.com under "subscriber access." For assistance, contact customer service at firstname.lastname@example.org or (800) 688-2421.]