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One year after the Pawnee County Health Department was awarded a three year grant through the Kansas Health Foundation to support breastfeeding mothers and babies, the project team is amazed with the progress achieved and also optimistic with the work ahead. The Lactation Assistance Access in all Counties Taking Action (LAACT-Action) project addresses the need to increase breastfeeding rates, specifically exclusive breastfeeding duration through 6 months, by providing physician referred prenatal breastfeeding education classes to expectant women and lactation consultations to breastfeeding mothers after delivery.

Public Health Departments in 20 counties are participating in the project: Barber, Barton, Comanche, Edwards, Ellis, Ellsworth, Ford, Harper, Hodgeman, Kingman, Kiowa, Ness, Pawnee, Pratt, Rice, Rooks, Rush, Russell, Stafford, and Trego. The health departments assist in linking physician referred expectant or breastfeeding women to an International Board Certified Lactation Consultant (IBCLC) in their area.

Robin Rziha, RN, IBCLC is the project coordinator as well as the Pawnee County Health Department Administrator. Rziha covers some of the counties as an IBCLC, teaching classes and making home visits to mothers. “I enjoy working with expectant women and assisting them postpartum with breastfeeding, it is extremely rewarding to play a role in helping a mother with nurturing her baby through breastfeeding,” says Rziha.

Rziha gives much credit to physicians and hospitals in helping to promote breastfeeding to their patients prenatally and referring for classes and postpartum visits if necessary. “The classes and consultations really took off once the word got out to the physicians. Physician support is integral to a woman starting out breastfeeding and continuing. IBCLC visits to the physician’s offices and hospitals, especially the OB and Pediatric providers have been critical to the success of this project.” The counties that have physicians encouraging their prenatal patients to attend a breastfeeding class have been the most successful. Research shows that mothers who obtain breastfeeding education prenatally are better prepared for a successful breastfeeding experience.

Julie Fields, IBCLC, covers eight south central counties and is based out of Pratt. She recently delivered her fourth child in May and has managed to juggle being a new mother again with helping new moms. She feels this project has provided the needed avenue for mothers to reach assistance with breastfeeding. “Prior to this project, I had many moms contact me as a lactation consultant in private practice that were uncertain how they would pay for services out of pocket or how their insurance coverage would reimburse them. With the LAACT-Action project we are able to provide the services and work with insurance companies to receive reimbursement. It has also encouraged the physicians in my area to refer to me for lactation services knowing that the moms will not have unexpected charges for these covered services.”

Monique Homes, IBCLC in Hays, covers the north central counties.

The grant project timeline originally had Holmes phasing in with her five counties of Ellis, Rooks, Rush, Russell, and Trego starting January 2017 but with the demand of this service she has been providing the in-home lactation consultations from the start and just last month started teaching classes in her five counties.

Hays is the only community in the 20 county region served by the project that employs an IBCLC in the hospital. Working together with the IBCLC there, Holmes has been able to provide continuity of care from hospital to home when mothers are most likely to encounter difficulties and abandon their goals for breastfeeding within the first few weeks.

The three IBCLCs met at the Pawnee County Health Department recently for a planning meeting to share progress with each other and determine areas where a greater need of focus should be. The project goal is to give all mothers access to professional lactation assistance in their communities.

While IBCLCs are available in most regions of Kansas, they are rarely available through healthcare establishments, especially in rural areas.

Rziha noted that local public health departments have been a good vehicle for the delivery of lactation assistance and envisions this service being offered through all local health departments in the state.

Sustainability for the project is being realized through preventive services under the Affordable Care Act. Lactation education and counseling through referral from a licensed health care provider is a preventive service and is covered by most private insurance plans. “Until this project, no clinics in Kansas were doing third party billing for the lactation services. In a way, we are pioneering an effort to make this service available to all mothers in Kansas in the near future. Presently, depending on where a mother lives in the state of Kansas will to a large degree determine the level of success she may have with breastfeeding. We want every baby born in Kansas to have the same opportunity for a healthy start in life through breastfeeding,” says Rziha.

The Pawnee County Health Department LAACT-Action project is made possible through funding from the Kansas Health foundation. The Kansas Health Foundation is a private philanthropy dedicated to improving the health of all Kansans. For more information about the Kansas Health Foundation, visit www.kansashealth.org.

For more information about the LAACT-Action project visit www.laactaction.com or contact the Pawnee County Health Department.