DC WIC POLICY & PROCEDURE MANUAL

Policy 2.013 1 | P a g e Title: Breastfeeding Aids and Accessories Category: Nutrition and Breastfeeding Education CFR Reference: 7 CFR § 246.14(c)(1) Policy Number: 2.013 Effective Date: 12/29/2000 Revised Date: 8/15/23

POLICY STATEMENT The Local Agency must make breastfeeding supplies available to participants to assist in managing breastfeeding concerns. PROCEDURE The Local Agency must: 1. Maintain a supply of breast pumps (manual and electric), as well as breast pads and other appropriate supports as determined by the State Agency. 2. Ensure that breastfeeding participants are instructed on hand expression of breast milk, breast milk handling and storage, and pump cleaning before issuing a breast pump. 3. Provide participants with resources to procure a breast pump from their insurance (if applicable) while pregnant or after delivery. 4. Provide training to staff on how to use and distribute breastfeeding aids and accessories. 5. Ensure staff document the aid in the MIS. 6. Nipple shields, if provided, must only be distributed under the guidance of a WIC-designated DBE or IBCLC as a short-term solution to breastfeeding issues. NUTRITION SERVICE ADMINISTRATION (NSA) FUNDS Local Agency allowable costs on NSA funds: • Breast pumps, • Breastfeeding aids that directly support the efforts of breastfeeding parents to remove milk from the breast and/or provide human milk to their infants, • Breastfeeding accessories are devices or products that, while not directly aiding the removal of milk from the breast, may facilitate breastfeeding. Unallowable NSA costs: • Breastfeeding aids/accessories that do not directly support the initiation and continuation of breastfeeding cannot be purchased with WIC funds. • Examples include topical creams, foot stools, baby bottles, nursing blouses, etc. (See the USDA Breastfeeding Policy and Guidance, 2016, for more information.) BREAST PUMPS The State Agency has discretion to determine under what conditions breast pumps may be issued to WIC participants (USDA Breastfeeding Policy and Guidance, 2016). The DC WIC State Agency allows breast pumps to be issued to any WIC participant who is breastfeeding. Breast pumps should not be issued to pregnant participants unless they are breastfeeding a WIC participant infant. DC WIC encourages participants to obtain a breast pump through their health insurance. The Local Agency must obtain approval from the State Agency prior to procuring breast pumps to align with cost containment measures. To be compatible with the MIS, the State Agency recommends that

DC WIC POLICY & PROCEDURE MANUAL

Policy 2.013 2 | P a g e the breast pumps purchased by the Local Agency have the serial number on the outside of the pump box. The State Agency recommends that participants be counseled on proper use of a breast pump, proper cleaning, and milk storage according to CDC guidelines. The State Agency recommends the Local Agency staff follow up with the participant after issuance of a pump. BREAST PUMP RELEASE LIABILITY FORM: The Local Agency must ensure each participant issued a breast pump signs the Breast Pump Release of Liability form (see attachment 2.013A Breast Pump Release of Liability Form). The signed form must be scanned in the participant’s record in the MIS. Retention of paper records is not required. NOTES ON BREASTFEEDING AIDS: 1. The Local Agency is not permitted to charge participants for a breast pump or any other breastfeeding aid or accessory. Breast pumps are not a guaranteed program benefit but are aids that the State Agency may choose to offer WIC participants. 2. DC WIC does not distribute multi-user breast pumps, nor does DC WIC accept returns of breast pumps once issued. 3. Provision of a breast pump or breastfeeding aid(s) must accompany appropriate breastfeeding education and support. The following are general circumstances when WIC staff may issue breast pumps to participants: a. The participant is having difficulty establishing or maintaining an adequate milk supply due to maternal/infant illness. b. During mother/infant separation (such as infant hospitalization or mother’s return to work or school); and c. To mothers who have temporary breastfeeding problems, such as engorgement. REFERENCES 7 CFR 246.14(c)(1) FNS WIC Nutrition Service Standard #8 FNS WIC Breastfeeding Policy and Guidance WIC Policy Memo #1995-05 Centers for Disease Control and Prevention (CDC), Proper Storage and Preparation of Breast Milk. Accessed at: https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm ATTACHMENTS & FORMS 2.013A Breast Pump Release of Liability Form Refer to a thorough guide to allowable costs in the Peer Counseling Program from Minnesota WIC, accessed at: https://www.health.state.mn.us/docs/people/wic/localagency/program/finance/peerallowable.pdf (2023, Minnesota Department of Health – WIC Program, health.wic@state.mn.us)