WIC Can Help
Campaign Brief
April 2010 – September 2010
August – September 2009
IC is developing two related, simultaneous
WIC is developing two related and simultaneous social marketing campaigns.
This packet contains an overview of the WIC Can Helptheme campaign –
This “campaign brief” was created to provide key information to help you execute the upcoming campaign.
You will find the following information:
Campaign Background
Key Data – The numbers that drive our campaign
Creative Platform – Foundation for the media materials
Common Theme Campaign Components
Idea Lists – New ideas
Resources
Campaign Background
WIC Moms want to breastfeed.
The majority of WIC mothers know breastfeeding is best, and most pregnant women state they intend to breastfeed: at their prenatal visit, 69% of WIC moms intended to breastfeed their infants; among moms who became WIC participants after the child’s birth, 78% intended to breastfeed.Most mothers initiate breastfeeding at birth, but many are at risk of failing to reach their breastfeeding goals. One third of WIC mothers are supplementing with infant formula by the end of the first week postpartum.
Changing reward structure and image
The new WIC food packages are intended to be an added incentive to moms who breastfeed. As more WIC mothers breastfeed, WIC’s reputation in the community as a credible, effective and sincere partner in breastfeeding promotion and support will be strengthened. Health Care Providers (HCPs)help by providing consistent breastfeeding messages,practicing supportive lactation management (10 Steps) and referring to WIC for benefits (food package, pumps, peer support).
Expected Impacts from both campaigns: “WIC Can Help” and “You Can Do It”
- Maximized potential of the new value-added breastfeeding food packages to improve exclusive, long-term breastfeeding rates.
- Improved reputation in the community as a credible, effective and sincere partner in breastfeeding promotion and support.
- Fewer WIC moms view formula feeding as an equal substitute for breastfeeding, and fewer feel the need to have formula to fall back on.
- Increased HCP knowledge regarding health disparities and breastfeeding intention, and increased evidence-based lactation support provided to exclusively breastfeeding WIC moms.
- Improved systems to ensure timely referrals to the supports that moms need to succeed. All moms need HCPs who are knowledgeable about their intention to breastfeed, and who can provide evidence based care to support feeding goals. Women with a breastfeeding action plan will be empowered to breastfeed. And WIC staff, prepared to educate and support mothers to anticipate pitfalls, strengthen their social supports and connect them to community resources, will be able to protect breastfeeding and improve health outcomes.
Key Data
Breastfeeding initiation by WIC moms has doubled since 1992, but many moms begin supplementing with formula soon after birth, and by the time their babies are 6 months old, half have completely switched to formula. For optimum nutrition, babies need to be breastfed for at least 12 months.
Over the past 25 years, the proportion of WIC children age 2-5 who are overweight for their age and gender has doubled, while the proportion of underweight children has been cut in half.
Moms need continuing support beyond breastfeeding initiation.
Breastfeeding success is affected by clinical practices, and skilled breastfeeding support (peer or professional) has been shown to enhance breastfeeding duration. Lack of support from health care providers can result in poor breastfeeding outcomes. Despite increasing knowledge of what constitutes good breastfeeding support, mothers continue to experience conflicting and incorrect advice, intrusive assistance and understaffed postnatal areas .
“I was highly disappointed with the lack of support/knowledge available about breastfeeding. There was no lactation consultant available to assist and the nurses were not much help.”
Moms and babies continue to need ‘Loving Support’ for breastfeeding success. Most mothers do not breastfeed as long as they had planned or desired. Shealy et al. reported 60% of breastfeeding mothers in the IFPSII study did not breastfeed as long as they had wanted to. Both WIC and non-WIC moms appear to stop breastfeeding too early by their own standard: only 21% of WIC ever-breastfeeding moms and 17% of non-WIC ever-breastfeeding moms reported stopping breastfeeding because it was “the right time to stop.”
Smoke-Free Zone Campaign Brief 3
Creative Workplan for WIC Can Help
WIC Can Help - social marketing campaign aimed at Health Care Providers (HCPs) in intervention sites (Rutland, Middlebury, St. Albans) that partner/work with WIC to support breastfeeding success. The materials for this campaign will build on existing WICLoving Support Makes Breastfeeding Worktheme.
Description: The campaign materials for “WIC Can Help” will be designed to motivate HCPs to provide consistent breastfeeding information and support messages, and to work with WIC to provide coordinated care for mothers at risk of breastfeeding failure.
Timeline:Creative:January 2010– March 2010
Launch: April 2010
e Campaign Brief
Marketing Objective
Increase appropriate and timely MDreferrals for bf help and support to bf
Increase the percentage of VT babies that are fed only breastmilk for 4 weeks, 3 month, 6 months.
Communication Objectives
Moms want to bf - may need help establishing milk supply
Mom’s need your help – and are grateful when your help means they can fulfill their bf goal (Mom’s can breastfeed with Loving Support)
Prenatal message: Know the best practice basics (pee, poop, eat, cry, sleep), know who to refer moms to for bf help
Postpartum message: Any supplements impact mom’s milk supply, interfere with getting breastfeeding off to a good start
Outcomes:
Increase positive feedback to providers that refer moms to breastfeeding supports.
Recognize WIC has breastfeeding expertise, and that working with WIC increases breastfeeding success (exclusivity and duration).
WIC viewed as serious about supporting breastfeeding: support includes peer counseling, breast pump, and the ultra-deluxe food package.
Target Demographics
Pediatric, Family Practice and OB/GYN (Physicians, CNM’s, NP’s), Hospital Maternity staff
HCPs do not always know which patients are WIC participants- messages need to be somewhat global for all moms
Excluding hospital maternity staff, the breakdown among HCPs in the 3 target communities is approximately:
- 7 pediatric practices and 29 total providers
- 20 family practices and 77 total providers
- 9 OB practices and 16 total providers
- 5 midwifery practices and 21 total providers (none in St Albans)
- 7 general/DO practices and 10 providers
- Ratio of female/male providers appears to be ~ 60% female, 40% male
Peer Counseling community profile
Rutland - The Rutland District is the second largest in Vermont, with an average monthly caseload of approximately 1900 participants, with about 400 infants enrolled at birth each year. This caseload size provides a critical mass of breastfeeding women who will benefit from peer counseling interventions. The Rutland Breastfeeding Coalition is well-established and includes representation from a wide variety of community partners. The Coalition has identified the lack of early postpartum support for breastfeeding women as an area needing attention. VDH staff in Rutland are experienced and enthusiastic about breastfeeding and peer counseling. Most staff has completed Best Start 3 Step Counseling training.
Challenges
There is a shortage of people with official lactation management credentials in the Rutland- one IBCLC certified lactation consultant. Therefore, the peer counseling project will need to include development of these resources in addition to recruiting and training peer counselors.
Middlebury - The Middlebury District has an average monthly caseload of approximately 900 participants, with about 200 infants enrolled at birth each year. This caseload size is smaller than the Rutland District where services began last year however their breastfeeding rates are higher so that a large number of those women enrolled are choosing to breastfeed and will benefit from peer counseling interventions. Middlebury’s Breastfeeding Coalition is well-established and includes representation from a wide variety of community partners including physicians and mothers. The current breastfeeding support group, Natural Beginnings, is co-led by an IBCLC from the community and the staff Nutritionist. The group is free and open to all moms in community. Meetings are held monthly at the district office and recently the group had suggested moving to a schedule of weekly meetings maintaining that one time a month is not frequent enough. There is an active La Leche League group that meets monthly in Bristol, a small town within Middlebury’s jurisdiction. The Porter Care Connection, offered by the local hospital provides follow-up for all infants born at their facility. The follow-up focuses on lactation support and connects families with WIC for additional follow-up.
In April 2009, the breastfeeding coalition sponsored a training attended by Nurses, NP and CNM from 9 medical practices in our group of HCPs. The following training needs identified by attendees included: how to help moms get off to a good start and support them in the first few weeks; addressing barriers to sustained breastfeeding; guideline for infant wt loss/slow wt gain; maintaining breastfeeding when mom and baby are separated ( NICU, back to work); addressing workplace challenges; addressing unsupportive family members
St.Albans - The St. Albans District is the thirdlargest in Vermont, with an average monthly caseload of approximately 1900 participants, with about 400 infants enrolled at birth each year. This caseload size provides a critical mass of breastfeeding women who will benefit from peer counseling interventions. The St. Albans Breastfeeding Coalition is newly energized and includes representation from a wide variety of community partners. The Coalition has identified lack of early postpartum support for breastfeeding women as an area needing attention. VDH staff in St. Albans are experienced and enthusiastic about breastfeeding and peer counseling. The breastfeeding designee has completed training as a certified lactation counselor and most staff has completed Best Start 3 Step Counseling training.
Psychographics
WIC moms feel that their health care providers do not support their decision to breastfeed.
WIC mothers do not consistently receive optimal care that protects breastfeeding. There are clinically important and statistically significant differences in the Baby Friendly hospital environment from WIC mothers’ perspectives, as shown in the table below:
Target Benefit(currently exploring themes through key informant interviews)
Satisfied patients (succeed in reaching their goal)
Healthier kids - Exclusive bf provides more benefits than mixed feeding (less respiratory illness, ear infections, etc….), Better health, more food. Exclusive breastfeeding for 6 months, continued breastfeeding with appropriate complementary foods for 6 – 12 months.
Reason to Believe
Mothers want to bf (80% of VT mothers start breastfeeding), mothers and babies that exclusively breastfeed are healthier, breastfeeding best for Mother/infant bonding, associated health risks vs best for babes, health benefits….differentiate between exclusive and partial breastfeeding
Advertising Strategy
Remind providers they can empower women through providing Loving Support (Nurture Nature).Providers are influential and make a difference.
Call to Action (spokesperson, leverage?)
Prenatal: Speak to your patients, Attend to the concerns of the parents
Know community resources that can help moms meet their goals
Postpartum: Warm Handoff - Know when and where to refer –and “hand mom off” to someone who can help
Know community resources that can help moms meet their goals
WIC Can Help - “Be prepared….know what to say, know who to call/refer to”
Common Theme Campaign Elements
Pee/Poop, Eat, Sleep, Cry, and Grow
All mothers and babies (WIC and Non-WIC) need support….referral…
Together we make a difference..
Campaign Support Materials
Web Site
include information from providers about the successful moms by infant age, back to work success stories, bf tips and information, links and downloads. (HCP to HCP – tips for success)
Web2.0, FaceBook, text messages, WIC Can Help sections to WIC pages
Educational Giveaways – training resources
- posters (Pee/Poop, Eat, Sleep, Cry and Grow) simplified anticipatory guidance?
- No Formula Zone Stickers – providers can label charts as a reminder that mom wants to bf.
for ideas for activities for the educational giveaways, go to the Idea List sectionSmoke-Free Zone Campaign Brief 5
Media Facts & Tips
o Key facts about formula exposure, as well as tipsfor creating formula-free environments,
o facts and tips can be used with local media to develop aregular newspaper column, or on the radio as tip of the week.(would be cool to coordinate a tip of the week as a text message sent to each mom based on the age of her infant…)
Policy Change Information (could make variety of tools available for changes in policy, clinic/practice environment, triage (LLL Answer Book) (7 steps recognition for practices)
- Information about current breastfeedingbest practices will be made availablein digital format.
- In addition, we encourage sites to send your local policytools and success stories, and tell your stories to your local media. (Every Baby…)
Breastfeeding Zone Pledge
- Encourage everyone to support bf mom/baby with an easy to reproduce pledge form. In Word, so you can add your practice logo too. (CDC Breastfeeding Baby Crib Cards)
- Download the birth plan (See Texas Hospital Experience tear off form) from the internet (Word document).
Other Resources
- Downloadable images of breastfeeding dyads and success stories.
Success Measurements
Breastfeeding rates / 2006 / 2007 / 2010 GoalBreastfeeding initiation (WIC) / 70.4% / 75%
Breastfeeding initiation (All Vermont**) / 75%
Breastfeeding at 1 week (WIC) / 68.8%
Breastfeeding at 4 weeks (WIC) / 57.3%
Breastfeeding at 8 weeks (WIC) / 46.0%
Breastfeeding at 3 months (WIC) / 42.4%
Breastfeeding at 6 months (WIC) / 31% / 50%
Breastfeeding at 6 months (All Vermont**) / 55% / 50%
Breastfeeding at 12 months (WIC) / 16% / 25%
Breastfeeding at 12 months (All Vermont**) / 34% / 25%
2004 / 2007 / 2010 Goal
Exclusive breastfeeding at 1 week (WIC) / 50% / --
Exclusive breastfeeding at 4 weeks (WIC) / 35% / --
Exclusive breastfeeding at 8 weeks (WIC) / 30% / --
Exclusive breastfeeding at 3 months (WIC) / --
Exclusive breastfeeding at 3 months (All Vermont**) / 47% / 40%
Exclusive breastfeeding at 6 months (WIC) / -- / 17%
Exclusive breastfeeding at 6 months (All Vermont**) / 16% / 17%
Smoke-Free Zone Campaign Brief 6
Workplace Information & Laws
BREASTFEEDING IS THE GIFT THAT LASTS A LIFETIME
Health experts in the United States and worldwide recognize breastfeeding as the best way to feed an infant. Breastfed babies have fewer ear, respiratory and intestinal infections; less frequent allergies and asthma; and less risk of developing chronic diseases and conditions, such as SIDS, diabetes, childhood cancers, obesity and high cholesterol. All of these factors aid in reducing the number of medical visits, prescriptions and hospitalizations. Many breastfeeding women juggle motherhood and working outside the home.
EMPLOYERS CAN HELP
In May 2008, Vermont added a new labor law that provides support for nursing mothers in their workplace to express milk. The law requires employers to provide the following for an employee who is a nursing mother:
(1) Reasonable time, either compensated or uncompensated, throughout the day for the employee to express breast milk for her nursing child; and
(2) To make a reasonable accommodation to provide appropriate private space that is not a bathroom stall, for the nursing mother to express milk.
The employer may be exempted from the above requirements if providing time or an appropriate private space would substantially disrupt the employer’s operations.
The law also prohibits an employer from retaliating or discriminating against an employee who exercises her rights as provided by the law.
Go to: for information on the law, breastfeeding, and working and pumping.
Campaign Idea List
The following ideas were developed to help provide quick and easy ways to fulfill goal ofdeveloping sustained activities:
PostpartumHospital menu…healthy foods for mom, breast milk for baby
Formula (requires medical order…)
Loving Support Materials from the past…
Posters, videos, radio/tv psa’s, pamphlets, Breastfed Babies Welcome Here, License to Breastfeed, It’s the law (factsheet on breastfeeding in the workplace law), Breastfeeding Friendly Employer,
Materials from CDC
Crib cards…
Loving Support Backpacks (Texas WIC)
Backpack given to WIC moms – contents include instructional DVD’s, burp clothes, tip cards, Just for Dad, Just for Grandparents, Amy Spangler’s Keep it Simple Book
Possible Distribution Points
o OB/GYN Practices
o Hospital
o WIC Clinic
o Childbirth Classes
o Breastfeeding Classes
“Welcome Back to Work”
Breastfeeding Coalitions can work with employers to support moms returning to work
Smoke-Free Zone Campaign Brief 7
new baby “I’m breastfed” crib cards “what me and my mom need” door hangers
Coalitions could work with a local printer to create door hangers- similar to
the “Do not disturb” signs that are found on hotel doors. Also check out the web site
for economical pricing.
Library Story Time
Story time at local libraries and community centers attracts a wide variety of moms (and dads).
Breastfeed Zone Stickers
Breastfeed Zone Media Tips
S Brief 9
Resources
The Vermont Department of Health WIC web site.
healthvermont.gov/wic
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