Partners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng

Partners in Narrowing Breastfeeding Support Gaps in Communities, by To-wen Tseng


Once again, it’s a new year with new hope and new challenge. While many of lactation consultants in San Diego County are continue to support breastfeeding families, it is very helpful to learn about the “RBLs”—Regional Breastfeeding Liaisons—at WIC.

Having that in mind, San Diego County Breastfeeding Coalition invited four local RBLs to talk about the program at a recent coalition general meeting. They are Kimberley Elkins (EdM, IBCLC, RBL) and Jennifer Nolan (RD, IBCLC, RBL) from American Red Cross WIC, and Laurel Hiroshige (RD, CLE, RBL) and Kim Speckhahn (BS, IBCLC) from North County Health Services WIC.

WIC is a special supplemental nutrition program for Women, Infant, and Children with a vision of “breastfeeding is the norm for WIC mothers and their infants up to age one year and beyond.” WIC is known in the community as a source for breastfeeding assistance and information. In San Diego County, WIC has approximately 50 registered nurses, 10 International Board Certified Lactation Consultants, 100 lactation educators, and several regional breastfeeding liaisons to serve the whole community.

WIC provides eligible families with checks for nutritious foods, nutrition education and counseling, referrals to community resources, and breastfeeding support and information. The program serve pregnant women and breastfeeding women up to one year; non-breastfeeding women up to six months.

The program goal of RBLs is to narrow the gaps in breastfeeding support, to improve awareness of WIC breastfeeding services, increase referrals between community and WIC and increase breastfeeding initiation and duration rates. An RBL is someone familiar with WIC, breastfeeding and the community. (S)he identifies the support gaps in the community, figures out the approach to narrow the gap, increases awareness, fosters relationships, encourages seamless breastfeeding support, and focuses on local needs.

“You’ll find the goal of the RBL program is actually very similar to the coalition’s,” said Speckhahn.

Currently the local RBLs are working on the projects to develop relationship with hospitals, providers and other community partners. When working with hospitals, RBLs provide 2 IBCLCs to see newborns at their first provider visit, and then follow up with a one-year project. According to the data analysis, after the intervention form RBLs, the exclusive breastfeeding rates increased by 22%. For one example, at Mission Mesa Pediatrics, the RBLs were able to raise exclusive breastfeeding rates at six month from 15% to 40%.

“We are very proud of this results,” said Hiroshige. She is now helping Tri-City Medical Center to become a baby-friendly designated hospital. “It’s interesting to see that we as an outside force came in and start that initiative.”

RBLs also assist employers with lactation accommodation, participate in local breastfeeding coalitions, and increase access to breastfeeding training.

To realize WIC’s breastfeeding vision, RBLs utilize the Spectrum of Prevention, a multi-faceted approach with a range of activities for effective prevention and public health, for their strategic plan. Originally developed by the Prevention Institute, the Spectrum is based on the work of Marshall Swift in treating developmental disabilities. It has been used nationally in prevention initiatives targeting traffic safety, violence prevention, injury prevention, nutrition and fitness; or in this case, breastfeeding gap. The Spectrum identifies multiple levels of intervention and helps people move beyond the perception that prevention is merely education.

Every lactation consultant can find a way to utilize local RBLs in his/her own breastfeeding support role. Contact WIC agencies for more information.

American Red Cross WIC 800.500.6411

North County Health Services WIC 888.477.6333

San Ysidro Health Services WIC 619.426.7966

Scripps Mercy WIC 619.260.3400

SDSU Research Foundation WIC 888.999.6897

Clinicas de Salud del Pueblo WIC 877.686.5468

This is an original post for San Diego County Breastfeeding Coalition by To-wen Tseng. Photo: Hiroshige, Speckhahn and Nolan (left to right) speaking at a recent SDCBC meeting.

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