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BREASTFEEDING DATA REPORT2022BREASTFEEDING DATA REPORT2022

Breastfeeding is ajourney. There are upsand downs and feelingsof accomplishment andfrustration. Michigan WICis there to help everystep of the way, nomatter what stage of thebreastfeeding journeyyou’re in. 2-USDA WIC Breastfeeding Support

TABLE OF CONTENTS5Trends in BreastfeedingInitiation, duration, and exclusivity81116182023Disparity in Breastfeeding RatesMichigan PRAMS comparisonLocal Agency MapsBreastfeeding statistics by local agencyBreastfeeding BarriersTop barriers for initiation and continuationBreastfeeding Peer CounselorsTrainings and Certificationsfor WIC staffAppendix 3Data Resources

A full-term infant typically increases their daily cryingaround two weeks of age. This is a normal surge indevelopment, but may contribute to increasedpostpartum depression and less breastfeeding.4DID YOU KNOW?

TRENDS IN BREASTFEEDINGSource: Michigan PedNSS 2012-2021WIC Initiation and Duration5

Source: Michigan PedNSS 2017-2021TRENDS IN BREASTFEEDINGWIC Exclusivity6

Source: Source: Michigan PNSS 2012-2021TRENDS IN BREASTFEEDINGWIC Initiation by Race and Ethnicity7

14.2% gap15.1% gapInitiation16.5% gap20% gap1-Month Duration Disparity in Breastfeeding RatesComparison Between All MichiganNon-Hispanic White and Non-Hispanic Black Mothers8Source: Michigan PRAMS 2004-2020

2-Month Duration3-Month Duration Disparity in Breastfeeding RatesComparison Between All MichiganNon-Hispanic White and Non-Hispanic Black Mothers923.2 % gap14.2% gap16.3% gap27.4% gapSource: Michigan PRAMS 2004-2020

10I strongly believe that there shouldbe more information for expectingmothers about breastfeeding andbreast milk. None of my doctorstalked to me about it; I've only beenasked if I am going to or not.Everything I've learned aboutbreastfeeding came from WIC. It'svery important that babies get thebest possible nutrition! - PRAMS participant Between four and six weeks after delivery, a parent'sbreast milk changes from a 90:10 whey to caseinratio to 50:50. Due to this change, parents maynotice less stooling. DID YOU KNOW?

Initiation by Local Agency11KEWEENAW BAY83.5%We attribute our breastfeeding initiationrates to our referral process, coordinationwith other programs, and our peer'spersistence, follow-up, and generalmanner of communicating with our clients.We offer group classes such asBreastfeeding Basics and ChildbirthEducation and a virtual support group. Being a tribal program we are able to tietraditional teachings and practices aboutbreastfeeding into our modern knowledgeof the subject. -Heather Wood, Acting WIC Coordinator-Miranda Mukka, Breastfeeding Peer Source: April 2022 Breastfeeding Rate and Duration ReportHighest Prevalence of Breastfeeding Initiation

2-Month Duration by Local Agency12BENZIE-LEELANAU67.5%Highest Prevalence of Breastfeeding 2-Month DurationWe are unique because of our low staff turnoverand the fact that almost every CPA on our staffhas received extensive education inbreastfeeding. Our peer will celebrate sevenyears of employment in June 2022! Our clientsbenefit from our agency’s commitment to ournurses and dietitian being cross-trained to offerboth WIC and Maternal Infant Health Program(MIHP). For MIHP clients, many WIC appointmentsare completed during MIHP home visits. Becauseour clients have access to the same MIHP/WICnurse during their pregnancy, delivery, and first-year postpartum, they form a relationship with atrusted and knowledgeable mentor to help themreach their goals! -Autumn Jurek, Personal Health Supervisor-Mariah Kaufman, RD, WIC CoordinatorSource: April 2022 Breastfeeding Rate and Duration Report

6-Month Duration by Local Agency13MARQUETTE40.5%During COVID, we had to quickly come up with somecreative ways to reach and connect with our families.Every month we send a personalized text message to allof our pregnant and breastfeeding families. This messageincludes an invitation and link to our virtual mom’s group,Baby Bistro, along with a listing of the breastfeedingclass offerings for the month. The classes are presentedlive through Google platform and parents are able toremain in the safety of their home and still receivevaluable information. We found that families who maynot have been able to attend classes or support groups inperson because of transportation or child care issueswere able to log in and participate from home. Thisconnection helped us to form relationships and be aresource that our families were comfortable with eventhough we had never met in person. - Linda Marshall, IBCLC- Sarah DiLernia, Breastfeeding Peer CounselorHighest Prevalence of Breastfeeding 6-Month DurationSource: April 2022 Breastfeeding Rate and Duration Report

11+ Month Duration by Local Agency14MARQUETTE7.4%I attribute our high breastfeeding rates to thededication that our WIC team has in providingbreastfeeding promotion and support to ourclients and community. We've been growingour breastfeeding program since 2010 whenour Peer Counselor program began, and ourstaff consistently seeks out opportunities formore education. Our lactation team offersseveral classes and support groups everymonth in addition to providing one-on-onesupport. We have a good working relationshipwith our local birthing hospitals and provideroffices and are viewed in our community asthe go-to breastfeeding people. -Jolene Spencer RN, BSN, CLCWIC Coordinator Highest Prevalence of Breastfeeding 11+ Month DurationSource: April 2022 Breastfeeding Rate and Duration Report

15 An infant goes through noticeable changes in theirsleep cycle around one month after delivery. They mayenter active/light sleep more frequently, during which ababy may wiggle, open their eyes, and even vocalize.Sound familiar? You've got it! These sound like hungercues! If given a few minutes, an infant may fall backinto still/deep sleep on their own. DID YOU KNOW?

Enrolled in WIC Eligible but not enrolled in WIC0% 10% 20% 30% 40% 50%Didn't want to Didn't like breastfeeding Other children to take care of Went back to work Tried but it was too hard Breastfeeding BarriersInitiation16Comparison Between Those Enrolled In WIC and EligibleBut Not Enrolled In WIC During PregnancySource: Michigan PRAMS 2016-2020

Enrolled in WIC Eligible but not enrolled in WIC0% 20% 40% 60%Not producing milk Milk didn't satisfy Difficulty latching Nipples sore Went back to work Too many hosehold duties Baby not gaining weight Felt it was the right time to stop Continuation17Source: Michigan PRAMS 2016-2020Breastfeeding BarriersComparison Between Those Enrolled In WIC and EligibleBut Not Enrolled In WIC During Pregnancy

Breastfeeding Peer Counselors(BFPCs) add a critical dimension toWIC’s efforts to help parents initiateand continue breastfeeding. BFPCsprovide a valuable service to theircommunities by addressing thebarriers to breastfeeding througheducation, support, and rolemodeling. Breastfeeding Peer Counselors18What is a Breastfeeding Peer Counselor?100+PEER COUNSELORS SUPPORTFAMILIES ACROSS MICHIGAN119,645CONTACTS MADE BYPEERS BFPCs TRAINED ASSENIOR PEERS28114BF STAFF ATTENDEDTHE REGIONAL PEERTRAINING138BFPCs, PEER MANAGERS, ANDREGIONAL LACTATIONCONSULTANTS ATTENDED THESTATE PEER UPDATE

19L a S a u n d r a ( D e n i s e ) B e a s l e yA n n a B r o c kE d y e G a l v e zJ e n n i f e r G u d i t hD a n i c a H o w a r dE r i c a M c L e o dL i n d a M a r s h a l lI r a s e m a M a r t i n e zC h e r y l P o l kK e l l y R u t zK r i s t e n S y t e kC o l l e e n U n s a lK e v a W i l l i a m sBreastfeeding Peer Counselors2021 WIC Breastfeeding Award of Excellence Winners Each year, the Food and Nutrition Service WIC program grants the WIC Breastfeeding Award of Excellence (formerly known as theLoving Support Award of Excellence). The award program was established to recognize local WIC agencies that have providedexemplary breastfeeding promotion and support activities. The intent is to provide models and motivate other local agencies tostrengthen their breastfeeding activities, and ultimately, increase breastfeeding initiation and duration rates among WICparticipants. The award is given at three levels of performance that build on one another: Gold, Premiere, and Elite. This approach recognizesagencies that include those that are demonstrating model practices, as well as those who are at varying stages of implementingoutstanding breastfeeding promotion and support practices.GOLDAWARDDistrict Health Department #10Health Department of Northwest MichiganOakland Livingston Human Service Agency (OLHSA)SPECIAL RECOGNITIONSTo Peers who have 10+ years working for WIC

Trainings and Certifications forMichigan WIC Staff 20115LEVEL 3BREASTFEEDINGSTAFF48IBCLCS17721BREASTFEEDINGBASICSATTENDEESADVANCEDCLINICALSKILLSATTENDEES43516830670ATTENDEES OF BREASTFEEDINGCOORDINATOR TRAININGATTENDEES OFBREASTFEEDING PEERMANAGER TRAININGCLS TRAININGATTENDEESMILKEXPRESSIONTRAININGATTENDEESWIC STAFF RECEIVEDBREASTFEEDING TRAININGTHROUGHOUT THE YEAR161ANNUAL WIC CONFERENCEBREASTFEEDING SESSIONATTENDEES

21 It is normal for an infant around four months of age tobecome easily distracted while nursing. It may behelpful for parents to find a quiet space with less sideconversations and family activity. DID YOU KNOW?

22 Infants around nine months old may go through aphase of stranger and separation anxiety. Parentsshould anticipate giving their baby a little extra love,comfort, and patience.DID YOU KNOW?

APPENDIX The Pregnancy Nutrition Surveillance System (PNSS) is a public health surveillance system that describes thenutritional status of low-income pregnant, postpartum or nursing people enrolled in federally-fundedmaternal and child health and nutrition programs. In Michigan PNSS, data is collected solely from WICclients. Self-reported demographic, behavioral, and health information is collected at the local WIC agencyand verified by a nurse, registered dietitian, nutritionist, or other health professional. Anthropometricmeasurements (height, weight, and birthweight), clinical nutritional indicators status (i.e. hematologymeasurements), and breastfeeding practices are also collected. The Pediatric Nutrition Surveillance System (PedNSS) is a public health surveillance system that describesthe nutritional status of low-income infants and children enrolled in federally-funded maternal and childhealth and nutrition programs. In Michigan PedNSS, data is collected solely from WIC clients. Self-reporteddemographic, behavioral, and health information is collected at the local WIC agency and verified by a nurse,registered dietitian, nutritionist, or other health professional. Anthropometric measurements (height, weight,and birthweight), clinical nutritional indicators status (i.e. hematology measurements), and breastfeedingpractices are also collected.The Michigan Breastfeeding PlanBreastfeeding Rate and Duration ReportThe Biannual Breastfeeding Rate and Duration Report is a point-in-time ad hoc report that provides thebreastfeeding duration and rate for all local WIC agencies across the state. The report depicts infants'duration of breastfeeding and shows the drop off of clients at each breastfeeding duration interval, thushighlighting critical points of intervention for breastfed clients. A count and rate are provided for eachbreastfed duration interval. PedNSS PNSSPRAMSThe Michigan Pregnancy Risk Assessment Monitoring System or PRAMS is a project that, with help from ourpartners at the Centers for Disease Control and Prevention (CDC), gathers high quality, population-based dataabout maternal attitudes and experiences for all mothers before, during, and after pregnancy. With the datacollected from this survey, we can help improve the health of mothers and their babies throughout the State ofMichigan.23H.U.G. Your BabyBased on child development, lactation and pediatric literature, H.U.G. (Help, Understanding, Guidance) YourBaby’s trainings and resources help parents (and the professionals who serve them) understand a baby’s bodylanguage in order to prevent and solve problems around eating, sleeping, crying, and parent-child interactionand to promote breastfeeding duration.Data Resources

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulationsand policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex(including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rightsactivity.Program information may be made available in languages other than English. Persons with disabilities whorequire alternative means of communication to obtain program information (e.g., Braille, large print,audiotape, American Sign Language), should contact the responsible state or local agency that administersthe program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the FederalRelay Service at (800) 877-8339.To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA ProgramDiscrimination Complaint Form which can be obtained online at:https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA.The letter must contain the complainant’s name, address, telephone number, and a written description of thealleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) aboutthe nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must besubmitted to USDA by:(1.) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or(2.) fax: (833) 256-1665 or (202) 690-7442; or(3.) email: program.intake@usda.gov This institution is an equal opportunity provider.