WIC Reps Bridge Gap Between Community and Hospitals through Breastfeeding Support

Posted March 08, 2016 by Sonya Spillmann, RN

Woman and Infant With Worker
“The biggest benefit of having WIC representation on these teams is helping moms to receive consistent, evidence-based information throughout their continuum of care,” explains Veronica Hendrix, program coordinator for the Texas Ten Step Program.

With both large urban and rural areas in Texas, sharing consistent and accurate information about the benefits of breastfeeding with mothers and healthcare workers is an enormous undertaking. One statewide initiative, the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative, is harnessing the power of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) staff, using them as conduits for communicating evidence-based practices and offering guidance to both mothers and healthcare providers.

“We have WIC clinics located all over the state and WIC representatives are like foot soldiers on the ground getting the information out about our state and local breastfeeding resources,” says Veronica Hendrix, LVN, IBCLC, RLC, program coordinator for the Texas Ten Step Program and who oversees WIC representatives in the Star Achiever project. “We are proud of the hard work and time that WIC has dedicated to this initiative. It has been a large scale effort including directors, breastfeeding coordinators and peer counselors, all of which have served on teams since the project’s beginning in 2013.”

The goal of the collaborative is to increase the rates of exclusive breastfeeding through the hospital stay, decrease in-hospital formula supplementation and connect mothers and their families to post-discharge community resources. Participating birthing hospitals form multidisciplinary improvement teams, which are made of members from hospital leadership, nursing management, physician and nursing staff, lactation support, WIC representatives and breastfeeding mothers. WIC’s involvement helps to bridge the gap between the community and public health sectors by working on collaborative projects and building resources.

“The biggest benefit of having WIC representation on these teams is helping moms to receive consistent, evidence-based information throughout their continuum of care,” explains Hendrix. “We’re helping to break down silos of information so that throughout her perinatal experience a mother feels supported—in whatever feeding decision she makes.”

On the Ground Educators

Claudia Gernand and Maricella Smith are WIC representatives serving UTMB Angleton-Danbury Hospital and Brazosport Regional Hospital respectively. As part of their improvement team work, these women visit their hospitals two times a week to offer one-on-one breastfeeding support to WIC moms, communicate with staff on evidence-based practice, and provide education to pregnant women during birthing classes.

Smith is also in the process of meeting with all the OB-GYN and pediatric offices in her area, to build relationships and educate them about the collaborative. She’s working to provide a binder for each practice with breastfeeding education material and WIC referral criteria.

“I hope mothers will hear a consistent message within the community, such as the benefits of skin-to-skin contact, not using pacifiers, and rooming in to reinforce what they will experience in the hospital after birth,” says Smith.

Christine Wiseman, RN, IBCLC, manager of the Lactation Care Center of Dallas, and Parkland Hospital improvement team member, identified a need for clinical training for healthcare providers. Under her direction, three hospitals and the Dallas WIC Lactation Care Center created “The WIC Hands-On Breastfeeding Training,” where providers observe or directly participate in breastfeeding support. The training includes sessions on latch and positioning, hand expression, supplementation, breast pump use, skin-to-skin contact, and supportive language for the initial breastfeeding sessions in the hospital setting. Since its start in 2013, approximately 1,500 health care staff has received this training. The training has been so successful that it has been adopted by neighboring Tarrant County WIC who began training healthcare providers in 2016.

“I’m passionate about training healthcare providers,” says Wiseman. “Ultimately my goal is that all of this will increase initiation and duration of breastfeeding and lead to healthier moms and babies.”

Wiseman also partnered with the pediatrician on Parkland’s improvement team, Elizabeth Stehel, to create training for medical students and residents during their pediatric rotations. Each participant comes to the lactation clinic for education on breastfeeding and how they can support mothers from the hospital to the community setting, completes skills training, and observes breastfeeding consultations at the Lactation Care Center. To date, about 420 physicians and students completed this education.

The improvement team’s efforts at Parkland have the potential for major impacts in the community. Last year, Parkland delivered 10,200 babies (they are currently on track to deliver 12,000 this year), so participating in the state’s Star Achiever program (and firmly on their way to obtaining Baby-Friendly designation) is a remarkable accomplishment for such a large facility.

“It’s a very exciting time. This is going to be like making history,” Wiseman says. “You can do amazing things together when you have the right team with the same common goal to help our moms and babies.”



Learn more about NICHQ’s breastfeeding work and how you can partner with NICHQ to help your hospital to improve maternity care practices.


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