Quarterly Meeting Minutes

Quarterly Coalition Meeting
Fremont Medical Center
5/1/18

Watch meeting video here.

1. Member Introductions: Carolyn Tubrick, Deanne Birkestrand, Jackie Moline, Kaiya Mears, Leah James, Lisa Lecht, Nicole Engelbart, Stacey Roach, Amanda Drier, Narissa Scales, Tiffany Keller, Stephanie Arnold, Arli Boustead, Peggy Brown, Marina Channer, Holly Dingman, Virginia Duff, Nicole Engelbart, Kelli Hansen, Tiffany Keller, Lora Marshbanks, Tracy Moore, Kimberly Peters, Dionna Schmidt, Rachel Sazama, Kailey Snyder, Jennifer Lee, Amy Potratz, Deanna Stoffel, Kayla Abel
2. Breastfeeding Super Moms: We recognized three Breastfeeding Super Moms from Fremont: Stephanie Arnold, Virginia Duff, and Jenn Lee.  Each of these moms has breastfed multiple babies through many difficulties, and continue to be strong resources for other women.  We are going to recognize them individually on social media, so stay tuned for those posts!
3. Group and Community Updates
   1. Fremont – A lot of regular moms have been attending their support group.  Numbers seem a little down since the fall.  Had a great event and gave out t-shirts.  There are some for purchase as well.  A Midland student did a little powerpoint and did a survey to those attending the event as well.  Gearing up to do tents at Fremont Days and Dodge County Fair.  Going to start doing the Business Case meetings with local employers.  Have 5 CLCs in their hospital after this last round of training.
   2. Omaha – Community Perinatal and Breastfeeding Resource has been created by Douglas County Health Department to give to participants.  They are updating it and putting it on the Douglas County website – douglascountyhealth.com.
   3. MilkWorksO, Douglas County WIC, Children’s, One World – held a culturally diverse breastfeeding educator course for women from South Omaha.  It was very successful and the women have been added to the coalition list serve.
   4. MilkWorks has grants to work on post partum depression screenings related to breastfeeding.  They’re doing education and referrals now.  This is a year long project they’re involved with.
   5. Kailey with UNO is looking at health behaviors of breastfeeding mothers for her research project.  Looking at physical activity and what they need to be physically active.  A lot of moms aren’t exercising because of fears of milk dropping.  She’s also interviewing rural and urban moms across the state about general health behaviors.  Finding really interesting info!  Let us know if you’re a breastfeeding mom who’s willing to take the survey!
   6. Lincoln – Their big project is working on a video series for moms that will be breastfeeding info broken into segments (prenatal, establishing in first few months, maintaining supply).  Good info to help remind moms.  UNMC College of Nursing students worked with Lincoln WIC clinics to highlight bright spots of successful moms and what supports were most helpful. Some moms said it took a year or even second babies to feel comfortable.  Working with Children’s on GO NAP SACC training.
   7. Children’s – hosted the first journal club.  There were mixed reviews on the presenter but there was great conversation at the end.  There are plans to host quarterly.  They will be in person at Children’s and the Webx option.  Not sure the next topic but it’s $20 and CERPs are available. The next meeting is in July.  Holly attended the Nebraska Dietetic conference and there are some extra materials and was a great place to reach professionals interested in breastfeeding.
   8. Kearney – Locally the coalition is ready to embark on corporate sponsorship ideas.  Receive recognition as a sponsor in community breastfeeding pumping rooms.  They think it’s best to hand deliver versus a mass mailing.  During WBW hoping to have a glow run/stroller race and use the raised funds to provide refreshments.  Also want to encourage people to do the Big Latch On, Miracle Milk Stroll, etc before the weather gets too hot. 
   9. VNA – Kaiya received a grant from early childhood services to help with the teen mom program.  They initiate well but duration isn’t great.  She will be starting a monthly support group at the end of May and gets to work another day of the week to reach those moms and help improve rates.  They also get to do a training with collaborating agencies.
   10. Milk Storage at Daycare - Local Kearney mom was wondering if the daycare milk storage policy had ever been revisited?  Rules and regs have not been updated, but there’s been talk that they’re wanting to update them.  Members of the coalition have met with the team at the state to point out the challenge that moms have with storage.  Through GO NAP SACC training they put together a comparison between state licensing and ABM guidelines and talk about how to manage the conversation.  Ultimately the responsibility is on the mom to manage her supply – but she needs to have a heads up that if she brings in older milk that they may reject it.  Sometimes we ignore small barriers, but we don’t realize how much of a barrier this causes.  When moms are new they want to do what’s right for baby, don’t want daycare mad, etc.  We could push out NAP SACC comparison. The coalition could lead the effort with the help of organizations in this room.  We could have a larger educational campaign.  We need to continue to push to help change the regulations.  We need to come up with shared language around what we do recommend.  We could share who to contact and what message we want to convey.  If you’re interested in helping lead this effort, please let us know!
   11. Fillmore – We have hosted two support groups. The first one had 6 attendees who dropped in at various times. The second one, today, had two mothers with new babies come. It wound up lasting nearly two hours as discussion was wonderful. Everyone has been very excited to use the scale. There is an article in the paper coming out in the next two weeks to build awareness about the support group. We are also going to promote a virtual support group via facebook to connect mothers locally who are unable to come to physical meetings.
       
       We have ordered Really?Really! materials and will be putting them in the "new pregnancy" or "going home" folders where appropriate as well as using the 9 steps as a base for our breastfeeding class. We are improving the process for registering mothers for class during prenatal appointments and the hospital has agreed to provide scholarships for patients who are unable to afford the class on their own. 
       
       We have identified that the training we want to provide to hospital nurses and providers needs to focus on the immediate post birth period and how what we do can really impact breastfeeding. I think that the Really? Really! approach would be great. I think that a presenter other than myself would be very helpful in the reception of this information. As we are trying to update our policies there is significant push back on changing current practices that are not evidence based (encouraging c-section mothers to keep their baby in the nursery for the first 24 to 48 hours) Nurses also want to do an anomaly check and pass an NG tube before allowing a newborn to go to breast. If you have any ideas with how to respond that would be great.
   12. Thayer – We had the tent on display during the Thayer County Health Services Kids Day on April 15th. We are going to have an article in the paper to publicize the tent and offer its use at area events.
   13. Santee Sioux - We are working on a class for the Community on the importance of breastfeeding.  We have put educational info in the Baby layette bags given out to all new prenatals. Working on an educational booth to set up for the annual Santee health fair in June.
   14. Crete - Our first Mommy to Mommy Breastfeeding support group will be May 22nd. (We collected surveys and most moms would like to meet once a month during the morning – 100% of surveys from hospitals said they didn’t want info and those who work for WIC said they wanted more info). We received a small donation and we will get the Welcome Baby bags. (In progress). We filled out an application to receive donations from Walmart and we are waiting for their response.  WIC is really focusing on breastfeeding from 24 weeks pregnant till baby is born.  All the clinics are putting a focus on breastfeeding and have a great start.  Doing some one on one training, but don’t have high enough numbers to warrant larger prenatal classes.
   15. Southeast District Health Department – Their coalition meeting is tomorrow.  Each community within their coalition will host a stroller walk as a fundraiser to help purchase a breastfeeding tent for breastfeeding events.  They can allow organizations to rent it as well.  Purchased EnJoy courses for staff development and have two modules available at their own pace online.  One hospital is using it as part of their annual training so all of their staff are going through independently and will discuss and have further training as a group.  The home visitation training department has gone through the modules and used that to develop breastfeeding support for parents.  They have two new CLCs in the area as well.  Their numbers for trained professionals are lower, so very glad to have the new trained professionals.  They are working with Sixpence to offer parent education and let them know the resources and services available. 
4. Leadership Team Update
   1. Financial – Kelli Hansen 
      We are 75% of the way through our DHHS Year 5 grant.  At this time we’ve requested about $20,000 of the $30,000 and look to be on track for the rest of the grant.  We also received $68,000 from CHI Health and are on track with the projects and funding from them as well.
   2. Project and Communication Updates - Kelli Hansen
      1. Stats: We’ve had 884 visits to our site since our last meeting (Feb-Mar).  This is down from the previous quarter.
      2. 2,418 “Likes” on Facebook, up 57 since our last meeting!
      3. 447 Twitter followers, a 2% increase from last quarter.
   3. Membership – We started our new membership drive at the Olson Center in August.  As of right now, we’ve had 269 new and renewing members.  If you haven’t done so yet, please do!
   4. We’ve also created a new Partnership packet and want to thank our current funding partners: CHI Health, Children’s Center for the Child and Community, and the Department of Health and Human Services.  We also want to thank our fiscal agent, MilkWorks.
   5. BFF Awards since our last meeting:
      ​​​​​​​Congrats to our newest BFF Award: Sidney Regional Medical Center.  If you’ve had a great experience with your employer, or know someone who has, please nominate them here: http://nebreastfeeding.org/business-of-breastfeeding/bff.html
   6. The majority of our upcoming projects are tied to different strategic plan goal priorities, so we will discuss those in momentarily!
5. Strategic Plan Update - 2016-2018 strategic plan that is ever evolving.  We started with 3 and expanded to 5 goals as the work defined itself.  The leadership team meets twice a year to touch base on the plan and our funding.  We will be looking at ways to bring the membership in to the discussion for the next plan.
   1. Goal #1 – Holly Dingman - Goal 1 is focused on the coalition’s infrastructure.  We knew we needed to look at our funding structure and diversifying our structure.  We decided we’re not quite ready for 501c3 as there is some uncertainty around funding.  Regardless of where we are as a structure, we really need a business plan and find the financial stability.  WE have not had official positions within the LT, but as we evolve we found we need more structure.  We’re going to start having positions – chair, vice chair, finance chair, community engagement chair, research and evaluation chair, business case for breastfeeding chair, training chair and membership chair.  We hope to have $23,000 in basic operational funds so we are actively seeking to cover those with organizational partnerships.
   2. Goal #2 – Arli Boustead - Goal 2 is focused on provider education.  We’ve been very focused on healthcare providers, surveyed them and got some great information.  A master’s student had educated providers with the Really? Really. materials.  We’ve worked together on creating a toolkit from her research.  We have a letter of intent, smaller sample of print material (prescription pads and rack cards), flash drive with a PowerPoint presentation with evidence based research support.  We want CBI leaders to be the people to spread the word and do the presentation in their communities.  They also want to focus on developing the workforce (IBCLCs, CLCs, etc).  There’s also a lot of great opportunity for member engagement with this work.  Get hospital guidelines from Tami to include in the toolkits as well with most current, evidence based information.  MilkWorks, NPQIC, and NE BFC discussed if there is an additional need for telehealth options to support mom.  There does seem to be an interest in smaller communities.  They met Medicaid (MCO) providers to make sure they’re aware of the need for breastfeeding support and engage them to support telehealth for breastfeeding moms.  A national law was proposed by a senator from Minnesota to require MCOs to provide quality improvement metrics on breastfeeding.  
   3. Goal #3 – Kelli Hansen - We actually made most of our progress towards workplace support in Q2, with Brenda Bandy and Nicole Osborne.  We are still looking for CBI’s to take the work we did in Omaha and Lincoln into their communities.  We hope to take this into Fremont before the end of this Quarter.
   4. Goal #4 – Amy Potratz - Goal 4 is focused on Empowering Moms in the workplace.  They want to really recognize Super Moms who are helping share stories of encouragement and support for other moms.
   5. Goal #5 – Tami Frank - Goal 5 is focused on the Community Breastfeeding Initiatives.  We really want our CBIs to take the survey so we know what resources we can provide to help you in your journey.  We really want to bring all our communities together and share resources that are available.  We scheduled our first quarterly networking call.  The first one will be Thursday, May 17th at noon.  If you are working in a community and would like to participate in the survey and the quarterly calls, please let u sknow!
6. Member Sharing
   1. Nebraska WIC - Narissa Scales, WIC Director is leading a COIN around WIC peer counseling and the hospitals as a way to help get moms started.
   2. DHHS - Two weeks ago DHHS got their Notice of Funding Opportunity.  Breastfeeding is included. This one is all outcomes based with performance measures.  They will submit it by June 15th and hope to hear by September or October.
   3. NPQIC – Nebraska Perinatal Quality Improvement Collaborative works to make sure all moms and babies get evidenced based care practices.  They did work on mPINC data and have been working with hospitals over the last two years to improve our state ranking.  They’re moving forward with outcome measures in the hopes that that’s a motivating factor to get practices moving.  Working on exclusive breastfeeding in the hospital and initiation rate. Hope to share statewide findings next quarter.
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Next meeting is August 7, 2018 at Lincoln Lancaster County Health Department in Lincoln, NE.