GEORGIA WIC PROGRAM PROCEDURES MANUAL BF Breast Pump Issuance Policy No. BF-1260.06 Effective Date: October 1, 2016 No. of Pages: 3

Revised October 2018

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Policy WIC Competent Professional Authorities (CPAs), WIC Breastfeeding Peer Counselors (PCs), WIC Certified Lactation Counselors (CLCs), WIC Certified Lactation Educators (CLEs) and WIC International Board Certified Lactation Consultants (IBCLCs) that have been trained on breast pump competency may issue breast pumps to breastfeeding certified mothers on the WIC Program based on established need. Staff must complete an initial follow-up by contacting participants within one to five business days from issuance of manual pumps, personal double breast pumps, and multi-user breast pumps, to ensure pump usage is going well. When breast pump usage is not going well, refer participants to a Designated Breastfeeding Expert (DBE), WIC CPA, WIC IBCLC, for additional support and guidance.

Purpose To support a subset of lactating mothers and breastfeeding infants with demonstrated or potential lactation difficulties or special circumstances, such as returning to work or school, or medically fragile.

Procedures I. Local agency staff shall determine which pump best fits the participants’ need (manual, personal, or multi-user). See Quick Reference to Issuing Breast Pumps

II. WIC staff should issue a manual breast pump (or two pumps for double pumping) when the participant:

A. Has a short-term separation from their baby such as:

1. Looking for work

2. Working or going to school less than ten (10) hours per week

B. Has limited access to electricity when pumping

C. Requests a pump due to engorgement and has been assessed by the DBE(s)

III. WIC staff should issue a personal double breast pump when the participant:

Plans to breastfeed exclusively for four (4) to six (6) months without receiving formula from WIC and (one of the following):

GEORGIA WIC PROGRAM PROCEDURES MANUAL BF Breast Pump Issuance Policy No. BF-1260.06 Effective Date: October 1, 2016 No. of Pages: 3

Revised October 2018

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A. Works and/or goes to school more than 10 hours per week.

B. Plans to return to work within the next two (2) weeks.

C. Has exclusively breastfed an infant for at least four (4) weeks.

IV. WIC staff should issue multi-user breast pump when the postpartum woman:

A. Has a premature or medically fragile infant unable to feed at the breast

B. Is unable to feed at the breast due to their own medical issues

C. Is breastfeeding multiples and needs to increase milk production

D. Is having problems breastfeeding and must use pump to provide breast milk

E. Is unsure of her long-term commitment to breastfeeding and will be separated from her infant a significant portion of the day.

V. At the time of issuance of a breast pump WIC staff must:

A. Demonstrate 1. Hand expression 2. Breast Pump Assembly 3. Breast Pump cleaning guidance

B. Allow the participant repeat and demonstrate what they understand

C. Discuss United States Department of Agriculture’s Human Milk Storage Guidelines

D. Complete appropriate form or loan agreement and tracking guidance (See table below)

Pump Type Form to Use How to Track What To Do Manual Issuance Form Georgia WIC Inventory Log File Issuance Forms (in clinic or district designated areas) PDP Issuance Form Georgia WIC Inventory Log File Issuance Forms (in clinic or district designated areas) Multi-user Loan Agreement Breast Pump Inventory Tracking System • Complete all required issuance fields within the tracking system • Scan and Upload the Multi-user loan agreement • Follow-up on the participants’ need of the pump and document within the tracking system.

GEORGIA WIC PROGRAM PROCEDURES MANUAL BF Breast Pump Issuance Policy No. BF-1260.06 Effective Date: October 1, 2016 No. of Pages: 3

Revised October 2018

Page 3 of 3

E. Provide participant with a copy of the signed Issuance Form or Loan Agreement.

Authority 7 CFR § 246.14 Definitions/Supporting Information Certified Lactation Counselor (CLC) – is an individual that has demonstrated knowledge to construct and maintain conditions that predispose mothers and babies to an uncomplicated breastfeeding experience through counseling, education, and support. (Taken from Healthy Children’s Project, Inc) Certified Lactation Educator (CLE) – is an individual that educates, counsels, and supports families and the community by providing evidence based information about lactation and breastfeeding. (Adopted from http://www.cappa.net/lactation-educator) Competent Professional Authority (CPA) – An individual on the local agency staff who is authorized to determine nutritional risk and prescribe supplemental foods. The following individuals may be authorized and trained to serve as a CPA: physicians, nutritionists (bachelor’s or master’s degree in Nutritional Sciences, Community Nutrition, Clinical Nutrition, Dietetics, Public Health Nutrition), registered dietitians, licensed dietitians, registered nurses, and physician assistants (certified by the National Committee on certification of Physicians Assistants or certified by the State medical certifying authority), or State or local medically trained health officials. International Board-Certified Lactation Consultant (IBCLC) – an individual who specializes in the clinical management of breastfeeding. They are certified under the direction of the US National commission for Certifying Agencies. (Adopted from http://www.ilca.org/main/why- ibclc/ibclc) Designated Breastfeeding Expert (DBE) – Is an individual who is an expert with special experience or training in helping breastfeeding mothers and who provides breastfeeding expertise and care for more complex breastfeeding problems when WIC staff face situations outside their scope of practice. Individuals with this designation can be WIC staff including Breastfeeding Coordinators, Peer Counselor Coordinators, IBCLCs, CLCs, or CLEs, nutritionist, and nurses or community health care providers. The IBCLC is the preferred WIC DBE (2013 WIC NSS). (Taken from United States Department of Agriculture’s Breastfeeding policy and Guidance) Peer Counselor (PC) – A woman of the community with similar characteristics as the participants WIC serves; has successfully breastfed for six months; a current or past WIC participant. PCs offer para-professional level mother to mother support. Peers are encouraged to be available outside of normal clinic hours, and within various community settings.