BREASTFEEDING PROMOTION & SUPPORT WPPM # 630-15 Subject: Breastfeeding Peer Counseling Program Item: Continuous Quality Improvement

PURPOSE: Provides information on the requirements for a Continuous Quality Improvement (CQI) plan for the Breastfeeding Peer Counseling (BPC) Program. POLICY: I. All local agencies (LA) with a BPC Program must design a CQI plan to ensure quality peer counseling services which result in increased initiation, exclusivity and duration of breastfeeding. The LA must also include basic program requirements when conducting CQI and must specify more frequent review for new staff and for staff who would benefit from more frequent follow-up. PROCEDURE(S): I. Role of the PC Supervisor / International Board Certified Lactation Consultant (IBCLC) A. The PC Supervisor / IBCLC must conduct CQI at least quarterly and more frequently as needed to ensure PCs: 1. Provide appropriate and timely counseling using the CDPH/WIC approved methods, as specified in the WPPM 190-00 Staff Training, 630-13 Contacts, and 630-14 Training. 2. Document all USDA funded BPC Program contacts in the Peer Counseling Database (PCDB), as required by WPPM 630-13 Contacts. 3. Make appropriate and timely referrals as required by WPPM 630-12 Peer Counselor: Requirements and Responsibilities. 4. Refer to the International Board Certified Lactation Consultant (IBCLC) when there are breastfeeding concerns beyond the PC’s scope of practice. II. Support A. The PC Supervisor / IBCLC must support PCs by ensuring PCs: 1. Have the opportunity to see mothers face-to-face. 2. Have timely access to an IBCLC for assistance with breastfeeding problems outside PC scope of practice. 3. Serve BPC Program participants, while being paid with PC funds. 4. Have regular contact with their PC Supervisor / IBCLC in person, by phone or electronically. Revised California WIC Policy and Procedure Manual Page 1 of 2 March 7, 2013

BREASTFEEDING PROMOTION & SUPPORT WPPM # 630-15 Subject: Breastfeeding Peer Counseling Program Item: Continuous Quality Improvement

Revised California WIC Policy and Procedure Manual Page 2 of 2 March 7, 2013 5. Have regular opportunities to meet with other Peer Counselors (PCs) and participate in WIC staff meetings, as part of the WIC team. III. Evaluation of the BPC Program A. The PC Supervisor / IBCLC must evaluate the BPC Program progress by: 1. Conducting an exit survey of 5 percent of BPC Program participants for satisfaction within two weeks after leaving the BPC Program. 2. Reviewing and evaluating data regarding breastfeeding initiation, exclusivity and duration monthly and re-evaluating BPC Program services based on findings. 3. Documenting BPC Program time studies. IV. Community Assessment A. The LA must conduct an annual internal and external breastfeeding community assessment as specified by CDPH/WIC and must use the findings to determine their BPC Program and CQI goals. AUTHORITY: All State Memorandum (ASM) 04-27 – Breastfeeding Peer Counseling Grants/Training, April 8, 2004 Loving Support© Through Peer Counseling: A Journey Together – for WIC Managers, USDA, November, 2011 Loving Support© Frequently Asked Questions 2011 Loving Support© Model for a Successful Peer Counseling Program CROSS REFERENCE: WPPM 190-00 Staff Training WPPM 630-12 Peer Counselor: Requirements and Responsibilities WPPM 630-13 Contacts WPPM 630-14 Training