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Section 4.7: Designated Breastfeeding Expert MAY 2023 References: 7 CFR 246.11; USDA WIC Nutrition Services Standards; USDA Breastfeeding Policy and Guidance Policy: The WIC Designated Breastfeeding Expert (DBE) is an individual with special training and experience who assists WIC participants with complex lactation problems that are outside the scope of practice of peer counselors and other WIC staff. The DBE operates within the policies and procedures of the WIC program and within the context of WIC’s role for breastfeeding support. Each WIC Grantee shall identify a minimum of one Designated Breastfeeding Expert. Local agencies (LA) may have additional DBEs as needed. The local agency Breastfeeding Coordinator may also serve as the DBE if they meet the qualifications of the DBE. If the breastfeeding coordinator and DBE are not the same person, then these staff members should work closely together to coordinate lactation efforts in the clinic. WIC Grantees that are unable to meet the staffing standards must develop and submit a plan in writing to the state Breastfeeding Coordinator for referring participants with complex lactation concerns. The plan should include justification regarding the inability to meet the staffing standard, and identify at least one organization that will receive referrals from WIC and a process for how referrals will be made. Purpose: To support lactating families throughout the continuum of prenatal and postpartum services and to ensure families feel supported in their feeding decisions. Procedures Qualifications The WIC Grantee ensures that the WIC-Designated Breastfeeding Expert has all the following qualifications: ▪ Successful completion of the WIC Breastfeeding Curriculum (levels 1-4). ▪ More information on the WIC Breastfeeding curriculum is available: ▪ WIC Breastfeeding Curriculum ▪ WIC Breastfeeding Curriculum- Topic of the month ▪ Minimum of one year of experience in counseling lactating parent/infant dyads.

S E C T I O N 4 . 7 : D E S I G N A T E D B R E A S T F E E D I N G E X P E R T 2 ▪ Meets the education requirements: ▪ Is an International Board-Certified Lactation Consultant (IBCLC), or ▪ Professional with a nutrition degree (Master’s or Bachelor's degree in Nutritional Sciences, Community Nutrition, Clinical Nutrition, Dietetics, Public Health Nutrition or Home Economics with emphasis in Nutrition), or ▪ Licensed or Registered Dietitian, or ▪ Registered Nurse, or ▪ Physician’s Assistant certified by the National Committee on Certification of Physician’s Assistants, or ▪ Has completed a minimum of 8 college courses from an Accredited Institution in the Health Sciences (suggested coursework includes, but is not limited to, the following areas: Human Anatomy, Human Physiology, Biology, Infant Growth and Development, Nutrition, Counseling Skills, Sociology, Introduction to Clinical Research, etc.). Responsibilities of the Designated Breastfeeding Expert include: ▪ Provides expertise and care for more complex lactation problems when WIC staff face situations outside of their scope of practice. ▪ Provides follow-up lactation support to participants. ▪ Acts as a referral source for other WIC staff providing evidence-based information and clinical skills. ▪ Assesses and counsels parents and infants with complex lactation situations and contributes towards the development of a care plan. ▪ Communicates care plan to the WIC breastfeeding team, as appropriate. ▪ Documents contacts in the WIC Information System. ▪ Makes referrals to appropriate providers (e.g., physician, IBCLC, pediatrician) when encountering situations outside the DBE’s scope of practice, for further assessment and medical care, and/or to support continuity of care. ▪ May serve as a lactation resource and mentor for WIC agency staff. ▪ May provide lactation training for WIC staff. ▪ May promote lactation within the community. ▪ Maintains lactation credentials and certifications, if applicable, and acquires ongoing continuing education, including opportunities to shadow an IBCLC, as appropriate, to stay abreast of current lactation profession information and enhance skills. ▪ Attends state meetings/trainings and share information with staff. ▪ Consults with and seeks advice from state staff as needed.

S E C T I O N 4 . 7 : D E S I G N A T E D B R E A S T F E E D I N G E X P E R T 3 ▪ A sample job description for the Designated Breastfeeding expert is found in Exhibit 4-B: Sample Job Description for the WIC Designated Breastfeeding Expert. Guidance ▪ All local agencies would benefit from identifying community resources for complex lactation concerns and developing relationships and referral processes with these providers. Reference – Complete Listing of Hyperlinks USDA WIC Nutrition Services Standards (https://wicworks.fns.usda.gov/sites/default/files/media/document/WIC_Nutrition_Services_St andards.pdf) USDA Breastfeeding Policy and Guidance (https://wicworks.fns.usda.gov/sites/default/files/media/document/WIC-Breastfeeding-Policy- and-Guidance_1.pdf) WIC Breastfeeding Curriculum (https://wicworks.fns.usda.gov/resources/wic-breastfeeding- curriculum) WIC Breastfeeding Curriculum- Topic of the month (https://www.health.state.mn.us/docs/people/wic/localagency/topicmonth/bfcurriculum.pdf) Exhibit 4-B: Sample Job Description for the WIC Designated Breastfeeding Expert (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/exhbts/ex4/4b. pdf) Minnesota Department of Health - WIC Program 625 Robert St N, PO BOX 64975, ST PAUL MN 55164-0975; 1-800-657-3942, health.wic@state.mn.us, www.health.state.mn.us. To obtain this information in a different format, call: 1-800-657-3942 This institution is an equal opportunity provider.