Step Number 10

Establish Breastfeeding Support after Discharge

Ensure that mothers are prepared for discharge and informed about community resources to help them meet their breastfeeding goals.

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

Quote from an Expert

“Digirolamo and colleagues found that among mothers who intended prenatally to breastfeed for at least two months and who initiated breastfeeding, those who did not receive information about breastfeeding support groups or services prior to discharge had increased odds of discontinuing breastfeeding prior to six weeks after birth.”

DiGirolamo AM, Grummer-Strawn LM, Fein SB. Effect of maternity care practices on breastfeeding. Pediatrics.2008;122 Suppl 2:S43-49.

Primary Goals of Step 10

  1. Refer mothers to community-based breastfeeding support at discharge.
  2. Foster development of in-house breastfeeding support services if no adequate source of support is available for referrals.
  3. Include information at discharge to support mother’s plans for feeding with an emphasis on exclusive breastfeeding for six months.
  4. 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.

View Application and Support Documents

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.

Download Baby Friendly Guidelines

WIC Resources for Step 10

Partner with Texas WIC to learn more about the valuable resources listed below:

  • – Texas WIC’s breastfeeding information for moms.
  • – 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

Austin - Mom’s Place

McAllen - Lactation Care Center RGV

San Antonio - Lactation Support Center