Breastfeeding Policy and Communication of Policy
Practical and Educational

ABM Model Breastfeeding Policy (Updated in 2010)



CDPH Model Breastfeeding Policy (2005)


Kaiser Permanente Model Breastfeeding Policy (Updated in 2005)


AAP Model Breastfeeding Policy (2009)


New York State Model Breastfeeding Policy (2011)


IN Model Breastfeeding Policy (Accessed in October 2015)


MN Model Breastfeeding Policy (accessed in October 2015)


Journal of Human Lactation Model Breastfeeding Policy (2012)


UNICEF Model Breastfeeding Policy (accessed in October 2015)


Sources: ABM, CDPH, AAP, NY/IN/MN DOH, UVA, Journal of Human Lactation, UNICEF
Description: A collection of model hospital breastfeeding protocols and policies used around the country.

How to Have a Breastfeeding-Friendly Practice
Source: AAP
Description: A short form with bullet-point advice on how to become a breastfeeding-friendly office practice.
Date of Access: October 2015



Practical

ABM Physician’s Office Protocol
Source: ABM
Description:  A sample breastfeeding-friendly protocol for a physician’s outpatient office.
Date of Publication: Updated in 2013



CDPH Hospital Self-Evaluation Form
Source: CDPH
Description: An extensive self-evaluation form for hospitals concerning breastfeeding-related practices.
Date of Publication: 2005



Baby-Friendly USA Self-Appraisal Tool
Source: Baby-Friendly (via CDPH)
Description: A self-evaluation form for hospitals. Assess the progress made toward implementing Baby-Friendly practices.
Date of Access: October 2015



Maternal and Neonatal Policy Self-Assessment Checklist
Source: UNICEF UK
Description: A checklist meant to help appraise a given hospital’s policies regarding breastfeeding.
Date of Publication: 2014



Educational

Medicaid Coverage of Lactation Services
Source: CMS
Description: Overview of the basics of Medicaid coverage of lactation services.
Date of Publication: 2012



Payer Coverage of Breastfeeding Support
Source: USBC
Description: A model policy concerning insurance coverage of breastfeeding and lactation support services.
Date of Publication: Updated in 2014



Breastfeeding and Lactation: A Pediatrician’s Guide to Getting Paid
Source: AAP
Description: A billing guide to how to be reimbursed for providing lactation and breastfeeding services. Includes a list of ICD-9 and ICD-10 codes applicable to breastfeeding, as well as a guide on the situations in which to use them. NOTE: As of October 2015, healthcare has transitioned to using the ICD-10 codes.
Date of Access: October 2015



List of Barriers to Implementation
Source: CGBI
Description: A checklist of possible barriers to the implementation of baby-friendly practices in a facility.
Date of Access: October 2013



Infant Feeding Documentation Policy
Practical

Exclusive Breastfeeding Audit Form
Source: Texas Ten Step
Description: A sample audit form for providers to fill out. Documents feeding choice and – if that choice is not exclusive breastfeeding – why the mother is supplementing.
Date of Access: October 2015



Breastfeeding Choice Algorithm: Term and Preterm
Source: Erlanger
Description: Flow charts from Erlanger concerning how to deal with breastfeeding a newborn infant, both at term and preterm.
Date of Access: October 2015



Baby Feeding Schedule Documentation Form (1 and 2)
Source: Freeprintablemedicalforms.com, NICHQ
Description: Two sample medical forms meant to document infant feeding.
Date of Access: October 2015



Employee Breastfeeding Support
Practical and Educational

ABM Position Paper on Mothers in the Workplace
Source: ABM
Description: A summary statement presenting a sample protocol concerning breastfeeding mothers in the workplace.
Date of Publication: 2013



Practical

The Business Case for Breastfeeding: Easy Steps to Support Breastfeeding Employees
Source: MCHB
Description: Guide for employers detailing simple ways to support breastfeeding employees.
Date of Publication: 2008



The Business Case for Breastfeeding: For Business Managers
Source: MCHB
Description: Brochure describing the benefits of allowing breastfeeding in the workplace. Intended for managers and others in charge of businesses.
Date of Publication: 2008



The Business Case for Breastfeeding: Employees’ Guide to Breastfeeding and Working
Source: MCHB
Description: A guide for working moms with advice on how to make breastfeeding work while working.
Date of Publication: 2008



The Business Case for Breastfeeding Outreach Toolkit:
Outreach Guide
Outreach Resources
Presentation

Source: MCHB
Description: Toolkit intended to help an employer establish a breastfeeding friendly business. Includes a presentation, template promotional letters, example legislative language organized by state, and suggestions of policies and practices that promote breastfeeding.
Date of Access: December 2016



The Business Case for Breastfeeding: Sample Launch Announcement
Source: MCHB
Description: A sample email/letter for an employer to send out announcing the launch of a breastfeeding friendly program.
Date of Access: December 2016



Policy for the Support of Breastfeeding Employees
Source: MCHB
Description: A sample policy concerning a company’s support for breastfeeding employees.
Date of Access: December 2016



Lactation Support Employee Feedback Form
Lactation Program Assessment Form Source: MCHB; CDC
Description: Two different feedback forms, one for employees to assess the employer and one for employer self-assessment, meant to provide feedback on breastfeeding policies in the workplace. The evaluation guide, meanwhile, serves as just that – a guide to evaluating the efficacy and function of an employer breastfeeding program.
Date of Access: December 2016



Timeline for Implementation
Source: MCHB
Description: A sample 5-month timeline for implementing an employee breastfeeding policy and program.
Date of Access: December 2016



Implementation Guide Source: CDC
Description: A short guide with tips as to how to implement an effective breastfeeding program in the workplace and how to maintain interest in such a program.
Date of Access: December 2016



Assessment of Need and Interest
Source: CDC
Description: A form meant to help assess the need for a breastfeeding-friendly program at a workplace.
Date of Access: December 2016



Breastfeeding Room Sign
Source: printablesigns.net
Description: A sign to hang on a door indicating that the room is for breastfeeding.
Date of Access: October 2015



Sample Breastfeeding Workplace Policy
Source: CDPH
Description: Sample language for an employer breastfeeding policy.
Date of Access: October 2015



Setting Up a Lactation Room
Source: CDPH
Description: A guide to creating and setting up a lactation room.
Date of Access: October 2015



Sample Letter to Employer
Source: MA Breastfeeding
Description: A form letter from a physician to an employer concerning the need/right of a patient (new mother) to breastfeed or pump during the workday.
Date of Access: October 2015



Educational

Resources and Articles for Mothers
Source: LLL
Description: A list of articles (with links) that concern various aspects of working while breastfeeding. Intended for mothers and families.
Date of Access: October 2015



Support for Breastfeeding in the Workplace 
Sources: CDCUSBCUNCASTHO
Description: Statements from large organizations describing why and – more importantly – how large companies should support breastfeeding.
Date of Access: October 2015



The Business Case for Breastfeeding Posters
Source: MCHB
Description: Three different posters promoting the benefit of permitting employees to breastfeed on the job.
Date of Access: December 2016



Break Time for Nursing Mothers
Source: US Department of Labor
Description: An explanation of the regulations applicable to breastfeeding time at the workplace.
Date of Publication: 2013



Breastfeeding in Public Posters
Source: WIC/CDPH
Description: Posters stating the legal support for breastfeeding in public.
Date of Access: October 2015



Facility Receipt of Free Infant Formula
Practical and Educational

CMSS Code for Interaction with Companies
Source: CMSS
Description: A code to follow when dealing with any company attempting to market a product – e.g. breast-milk substitutes – to a hospital or other institution. Endorsed by the ABM, AAP, and many other medical organizations.
Date of Publication: Updated in 2011



International Code of Marketing Breast-Milk Substitutes
Source: WHO
Description: Official WHO document concerning the marketing and sale of breast-milk substitutes. Intended to protect and promote breastfeeding.
Date of Publication: 1981



​Trends of Distributing Infant Formula Packs
Source: Pediatrics
Description: Academic article looking at the trends in formula distribution out of hospitals between 2007 and 2013.
Date of Publication: 2015



Prenatal Breastfeeding Instruction
Practical and Educational

ABM Protocol for Prenatal Breastfeeding Support
Source: ABM
Description: A protocol describing the steps necessary to promote effective prenatal breastfeeding support.
Date of Publication: 2009



NYC Prenatal Curriculum
Source: NYC Health
Description: Comprehensive prenatal curriculum guide. Has information for both providers and expectant mothers. Topics organized by trimester.
Date of Access: December 2016



Prenatal Breastfeeding Education Curriculum
Source: Woodland Healthcare
Description: Comprehensive prenatal curriculum guide for expectant mothers.
Date of Access: October 2015



A Guide to Breastfeeding
Source: CDPH / WIC
Description: Comprehensive prenatal curriculum guide for expectant mothers. Available in English and Spanish.
Date of Publication: Updated in 2015



Benefits of Breastfeeding Games (Rummy and Bingo)
Source: Texas DSHS / CCNE
Description: A facilitator’s guide, along with bingo cards, rummy cards, and the like, to leading games as a way to teach expectant mothers about breastfeeding. Also has an evaluation form.
Date of Access: October 2015



Educational

Your Guide to Breastfeeding
Your Guide to Breastfeeding for African American Women
Source: Womenshealth.gov
Description: A 50-page guide to breastfeeding for new and expectant mothers. Available in English, Spanish, and Chinese. Moreover, there are two English versions, one for a general audience and one specifically intended for African-American mothers.
Date of Publication: 2011



Breastfeeding Q&A
Source: OWH
Description: Two-page list of common questions, with answers, that mothers have about breastfeeding.
Date of Publication: Updated in 2014



FAQs about Breastfeeding
Source: ACOG
Description: List of FAQs – and answers – about the benefits and process of breastfeeding. Source is targeted toward new and expectant mothers.
Date of Publication: 2013



Infographic of Breastfeeding
Source: BestStart
Description: Infographic addressing the issues of feeding frequency, stomach size, and urination/defecation frequency in newborns.
Date of Publication: 2009



Resources and Articles for Mothers
Source: LLL
Description: A list of articles (with links) that concern various aspects of working while breastfeeding. Intended for mothers and families.
Date of Access: October 2015



Busy Moms Brochure
Source: USDA
Description: Brochure that encourages moms to breastfeed even as they maintain a busy schedule.
Date of Publication: 2014



Confident Moms Brochure
Source: USDA
Description: A brochure encouraging moms not to be afraid of breastfeeding in public, if necessary.
Date of Access: October 2015



Trimester Brochures
Source: Erlanger
Description: Three brochures, one for each trimester, with important and timely information for mothers and their families. Available in English and Spanish.
Date of Access: October 2015



Ready, Set, Baby Collection
Source: UNC
Description: A breastfeeding guide for prenatal mothers. Available in English and Spanish. Comes with handout and flipbook guide for mothers.
Date of Access: October 2015



Every Drop Counts Prenatal Curriculum
Breastfeeding Top Ten Prenatal Curriculum
Breastfeeding: It’s Only Natural
The Golden Hour
Returning to Work

Source: Texas DSHS / CCNE
Description: Lesson plans and facilitator’s guides for leading a classes about the benefits of breastfeeding and other key issues. Targeted at expectant mothers.
Date of Access: October 2015



Prenatal Education Handout
Source: MN Breastfeeding Coalition
Description: A colorful guide to breastfeeding for both professionals and expectant mothers. Available in English and Spanish.
Date of Access: October 2015



How to Get Off to a Great Start
The Hospital Experience
Breastfeeding in Public
Source: Texas WIC, CDPH
Description: Colorful guides for expectant mothers on a variety of topics related to breastfeeding.
Date of Access: October 2015



Ready, Set, Breastfeed
Source: Loving Support (USDA)
Description: Brochure with breastfeeding tips for expectant mothers.
Date of Publication: 2014



Pregnancy and Prenatal: Go the Full 40
Source: Erlanger
Description: A sample two-page document describing all the key steps to take prenatally to prepare for birth and breastfeeding.
Date of Publication: 2012

Best Start Brochure
Source: bfclinic.com
Description: A three-panel brochure for the prenatal period supporting exclusive breastfeeding.
Date of Access: October 2015

Keys to Successful Breastfeeding
What and How to Prepare for the Arrival of Baby
Choosing a Breast Pump
Employment and Breastfeeding
What I Wish I Had Known
Source: Lactation Education Resource
Description: Various handouts for mothers and families concerning important prenatal topics.
Date of Access: October 2015



Pregnant Women and the Flu Shot
Source: CDC
Description: A fact sheet for both mothers and providers concerning the benefits of the flu shot during pregnancy.
Date of Access: October 2015



Understanding Breastfeeding Benefits
Source: NWLC
Description: A guide, intended for new mothers, explaining the benefits they will receive under the ACA and other insurance plans in regard to breastfeeding.
Date of Publication: 2014



Coordination of Lactation Care
Practical

Lactation Program Coordinator Job Description
Source: IBCLC
Description: Two-page document describing the role and responsibility of a lactation care coordinator.
Date of Access: October 2015



Educational

Position Paper on the Role of LCs
Source: IBCLC
Description: A position paper espousing the benefits of LCs. A lactation coordinator does not have to be a LC, but they are certainly candidates for the role.
Date of Publication: 2011 (E)