Implementation of Community Needs Proposal on Brest Feeding - Essay Example

Grant Proposal Implementation of Community Needs Proposal on Brest Feeding Implementation Plan for Grant Proposal Breastfeeding has been proven to be extremely important to the health of both mother and infant. Yet there is a very poor initiation of breast feeding in the population of women and babies in the target area. This area consists of Luce, Mackinac, Alger and Schoolcraft counties. Infants that are born to low income mothers in these counties are at even greater risk. There is higher mortality rate and higher incidence of chronic disease (Stanhope, 2010). The poverty rates for children living in these counties are 17% to 24.6%, (KidsCount, 2009) therefore there are increased state funded births. Statistical data from WIC tell us that 50% of the new mothers in this area initiate breast feeding but only 14.5% maintain breast feeding (WIC). This implementation plan will put into place a peer to peer breastfeeding program. The aim would be to improve the numbers of maintained breast feeding mothers and infants. Implementation Provision of Services The program is a peer to peer (buddy program) to support mothers attempting to breast feed. As noted, many women initiate the attempt (50%) but those who manage to continue are only (14%). There are many reasons for this, some of which are lack of support, confusion, fear, and anxiety (Stube, 2009). The primary goal of this program would be to increase the numbers of women who are able to maintain breast feeding. Keeping mothers breast feeding at least the first few months could improve the health of both mother and infant (Stube, 2009). It has been shown through several recent studies that peer coaching improves the continuation of breast feeding. Hoddinott, Chalmers, and Pell (2006) supported the fact that in some areas this has increased up to 35%. This is further supported by a quasi experimental evaluation done by Olson, Haidir, and Vanggel et. al. (2010) in which they found that peer to peer counseling improved initiation by 27 points and increased duration by 3 week. In Bangaladesh Hollander showed that peer counseling increased breast feeding at five months by 70% and Shafer, Vogel, and Vigas (2009) showed in their randomized control trial, an increase of 6% initiation and 9% continuation in rural low income women. Referral Peer support is provided through a network of volunteers that are trained in the problems related to breast feeding as well as having been successful at breast feeding themselves. This training will be initiated through the WIC and LaLeche League International program to assure that the new mothers are getting the support that is needed. The idea is to choose a supporting peer that has the same culture and socioeconomic background as the mother to be supported. The new mother may be referred in several ways including WIC, Public Health, Food Stamps, physician, social services, self referral and others. Access Once the mother has been referred she is contacted by a peer and given information, including classes that she can attend that prepare her for the breast feeding process. This includes such procedures as needed to harden nipples, decreasing pain on initiation of breastfeeding. After childbirth, the provide nonmedical assistance as needed to reduce frustration and anxiety in the new mother who is attempting to breast feed. This includes the mother who goes back to work. Often, the transition from breastfeeding to pumping and bottle feeding is extremely difficult (Dennis, Hodnett, & Gallop, 2002). The peer who has been successful through this transition can help quite a lot in improving this transition, keeping the mother breast feeding for a longer period of time. This program would be based in the community clinics in each of these counties but the peers are available through the hospital setting as well as phone. Telephone counseling and support are available 4 times per day. Peer Training Peers will be expected to attend classes on basic breastfeeding management, nutrition, infant growth and development, counseling techniques, and criteria for making referrals. These peers are trained in how to relate in a one on one relationship as well as a group relationship. These peers are certified at the end of their training. These peers will be monitored by a professional in each of the counties who is responsible for the program. That professional would be a Public Health Nurse who has access to consultation with nutritionists, and physicians on specific needs to come. Time Line Grant Approval Achieved 30 days from completed proposal Community Involvement and Choose Volunteers Start as soon as grant approved Complete within 60 days Training Volunteers Start as soon as grant approved Complete within 90 days Assure availability of rooms Start as soon as grant approved Complete within 30 days Push out posters, referral paperwork and availability calendars Start as soon as grant approved Complete within 30 days Provide survey results Start with ending of breast feeding of each mother Provide completed results in 18 months Provide Outcome measures Begin data with each referral Provide completed data in 18 months. Resources and Personnel Training rooms- These rooms will be needed not only for the training of peers but for the use of those peers for group and individual training of mothers to be. The use of local hospital meeting rooms is a good choice as there is little cost and easily accessed. Flyers, Posters, Bulletins-Informing those that can best use the program will best happen through physicians, social workers, and self referral. This will happen best when the information is frequently accessible. Posters and readily available information where mothers may go such as the WIC office will improve the numbers that refer to the program. Referral Paperwork, enrollment cards, and consent-This is needed to keep track of who is referred as well as what the results are. Outcomes will be measured through this paperwork. Enrollment cards will help with verifying those statistics and consenting the mother will assure that she is prepared for the use of this peer. Well Trained Peers- There will be a need of at least four peers in each county that are from different socioeconomic backgrounds and trained and certified. There will also need to be a supervisor for this group of people, preferably provided through the public health department and a breastfeeding class coordinator who is already available through the WIC program. Surveys--Surveys will be needed to distribute to both mothers and peers to determine how the program is working and the satisfaction level of the program. Measurement of Success Success in this program will be measured by--The % of infants breastfed at 2 months, 6 months, and 12 months at baby visits. The numbers of new mothers who are served by the program, and the satisfaction surveys from the program. Community Support This program will gain its best support through the Public Health System and WIC. NHS (National Institute for Health and Excellence) states that it is not matter of mother's and the community not understanding that breast feeding is important. The issue is more that women are so busy and doing so many things that it is difficult to determine how they can slow down long enough to do this without having a problem with anxiety and fear. This is where this program comes in and the community support from the program alone is important. There are many venues of support present at this time. Not only do WIC and the NHS support this program but WHO has come out as well as the US government on the side of importance of this program. Now is the time to initiate a successful program with so many large areas of support. References Collins, J., Wambach, J. David, R. and Rankin, K (2009) Women's Lifelong Exposure to Neighborhood Poverty and Low Birth Weight: A population-Based Study. Maternal Child Health Journal. 13:326-333. Dennis, C, Hodnett, E., Gallop, R. (2002) The effect of peer support on breast=feeding duration among primiparous women: a randomized controlled trial. CMAJ 166(1). Health of Canada. Toward a healthy future 1999: Ottawa: health Canada. Hoddinott, P., Chalms M,. Pell, R. (2006) One to one group based peer support for breastfeeding. Perinatal Care 33(2) 139-146. Hollander, D. Peer counselor's support is successful in promoting exclusive breastfeeding among Bangaladeshi Women. International Family Planning 27(1) Kids Count (2009). Michigan. Retrieved from http://datacenter.kidscount.org/data/bystate/Rankings.aspxstate. Le Leche League International: Available at http://lalecheleague.org/leaderinfo.html. NHS (National Institute of Health and Clinical Excellence. Available at http://www.nice.org.uk.usingguidance/commissioningfuides/breastfeed/commissioning.jsp Olson B., Haider S., Vanggel L. et.al.(2010) A quasi experimental evaluation of breastfeeding support program for low income women in Michigan. Maternal and Child Health Journal. 14(1). Schafer E, Vogel MK, Viegas S et.al. Volunteer peer counselors increase breast feeding duration among rural low income women. Issues of Perinatal Care 25(2). 101-106. Stanhope, M. and Lancaster, J. (2010). Foundations of Nursing in the Community: Community-Oriented Practice. 3rd edition. Mosby: Elsevier. Stube, A (2009) The Risks of Not Breastfeeding for Mothers and Infants. Reviews in Obstetrics and Gynecology. 2(4). Read More