Why Step 10?
Despite notable initiation rates, there is often a sharp decline in exclusive breastfeeding in the weeks following facility discharge.1, 2 You play an important role in connecting mothers with breastfeeding support services in their communities that can assist with post-discharge challenges.
Examples of breastfeeding support that have been instrumental in many communities include:
- Women, Infants, and Children (WIC)
- Breastfeeding clinics, such as WIC Lactation Support Centers* and Baby Cafés
- Breastfeeding Hotlines, such as the Texas Lactation Support hotline (855-550-6667). The hotline is available 24 hours a day, 7 days a week.
- Breastfeeding coalitions
- Mother-to-mother support groups
- WIC or other community-based peer counselors
- Community health workers, including promotoras for the Latino community which serve as cultural intermediaries between community and healthcare services
- Local doulas, midwives and lactation consultants
Develop individual care plans with mom prior to discharge to help her meet her breastfeeding goals and ensure continuity of care. When mothers know how to access care in a timely manner, problems are less severe and fewer resources are needed to resolve them.
* Centers funded by Texas WIC and Department of State Health Services Maternal Child Health
Primary Goals of Step 10
- Refer mothers to community-based breastfeeding support at discharge.
- Foster development of in-house breastfeeding support services if no adequate source of support is available for referrals.
- Include information at discharge to support mother’s plans for feeding with an emphasis on exclusive breastfeeding for six months.
- Schedule appropriate follow-up appointments with a physician or other lactation support service after discharge: at two to four days and again in the second week to ensure adequate infant feeding and continuity of care.
Ten Step Self-Assessment
Use the Ten Step Self-Assessment to help you evaluate your progress for this step. This self- assessment document does not have to be submitted with application.
New Applicants
- Use document checklist (PDF) to ensure appropriate support documentation is included with application.
- If your current practice does not meet these criteria, review the Ten Step Self-Assessment to assess how your facility might fully implement this step.
Re-Designation Applicants
- Review your individual Ten Step Scorecard from the last designation for change recommendations.
- Use the Ten Step Self-Assessment Tool to help plan for step-by-step improvement in any areas needed.
- Review the Baby Friendly USA, Inc. Guidelines and Evaluation Criteria to view full standard for this step.
WIC Resources for Step 10
Partner with Texas WIC to learn more about the valuable resources listed below:
- BreastmilkCounts.com – Texas WIC’s breastfeeding information for moms.
- TexasWIC.org – Full program information for families and health care partners
- Texas Lactation Support Hotline – 855-550-6667 (available 24 hours a day, 7 days a week, including holidays)
Texas Lactation Support Centers
Houston - The Lactation Foundation
713-500-2800, option 1
Dallas - Lactation Care Center
214-670-7222
Austin - Mom’s Place
512-972-6700
McAllen - Lactation Care Center RGV
956-292-7711
San Antonio - Lactation Support Center
210-207-7138
Resources
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Kellymom.com
General breastfeeding resource information for moms.
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Texas Breastfeeding Coalition
Nurses, physicians and lactation support staff stay connected by joining their local state breastfeeding coalition. Learn more about community activities, legislative efforts and educational opportunities.
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Mother’s Milk Bank at Austin
Information for families on receiving and donating banked donor breastmilk.
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Mother’s Milk Bank of North Texas
Information for families on receiving and donating banked donor breastmilk.
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Medication Questions
Information on safe medications to take during pregnancy and lactation.
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Texas WIC Breastfeeding Assessment and Counseling Form (PDF)
Designed for use in the WIC clinics, the form can be adapted and used in birthing facilities and outpatient settings.
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Texas WIC Video: Dads and Grandmas (English)
Breastfeeding support information from Texas WIC to share with moms and their families.
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Texas WIC Video: Papás y abuelas (Dads and Grandmas) (Spanish)
Breastfeeding support information from Texas WIC to share with moms and their families.
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Information for mothers on state and federal breastfeeding laws provided by Texas WIC.
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Becoming Baby-Friendly: Practical Solutions Toolkit
Resources from the State of Massachusetts (Mass.gov), including staff presentations and tools from their Ten Step Initiative.
Evidence to Support Step 10
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Academy of Breastfeeding Medicine (ABM) Clinical Protocol #2: Guidelines for Birth Hospitalization Discharge of Breastfeeding Dyads, Revised 2022 (PDF)
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Shakya P, Kunieda MK, Koyama M, et al. Effectiveness of community-based peer support for mothers to improve their breastfeeding practices: A systematic review and meta-analysis. PLoS One. 2017;12(5):e0177434. doi:10.1371/journal.pone.0177434
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Wagg AJ et al.Online social support group use by breastfeeding mothers: A content analysis. Heliyon. 2019 5 (3): e01245.
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Labarere J et al. Efficacy of Breastfeeding Support Provided by Trained Clinicians During an Early, Routine, Preventive Visit: A Prospective, Randomized, Open Trial of 226 Mother-Infant Pairs. Pediatrics 2005. 115 (2) e139-e146;