In regards to our HMHB Breastfeeding Comfort Line:

Our bf project is administrated through my agency, Healthy Mothers, Healthy Babies of Kern County.  We are a nonprofit free-standing 501c3 agency (which by the way, graciously will accept those tax refund checks you'll be getting in July as donations anytime!!).  Although we received free office space through one of our local hospitals - we have a local board of directors which makes all decisions.  There are other HMHBs all over the country, but most are basically departments within a health department or such.  I am the Executive Director and also serve as the Project Coordinator of our bf project.  I have a wonderful (!) Staff Analyst who is a CLE and coordinates our volunteers and analyses our statistics.  We are both independent contractors at 20 hours per week.

Our Comfort Line calls are routed through an Answering Service that makes a direct connection to the volunteer on call for the day.  Calls are answered seven days a week from 6 am to 10 pm - with messages taken during off-hours.  The volunteer on call for the day is responsible to check in at 6 am with the service and collect any off-hours phone messages.  The volunteer is also responsible to provide a contact phone number (the service has their home numbers in the system) if they are going to be somewhere other than the number they already have (i.e. work, cell number, etc.).  If a volunteer will be unavailable for a particular amount of time (i.e., driving to work, lunch, meeting, etc) it's the responsibility of the volunteer to let the service know to take messages and to contact the service once they're available once again.

So how do we get such great volunteers?  Well what we did was offer the CLE course at a significantly reduced rate through an application process (our grant provided 50% of the fee).  We then selected candidates from these applications.  Each candidate had to commit to volunteering one day per month for one year on our Comfort Line.  Our agency is in a lot of ways a coalition of health, mental health and social service agencies so it was not difficult to find applicants.  Although I must tell you that some of our best volunteers are just interested individuals (mommies!) - like, I'm sure you would find in La Leche Leagues all over.

When a call comes into the Answering Service, the operator takes a first name and phone number (mainly in case the call is lost along the way somehow - policy of the Answering Svc.) and contacts the volunteer.  We have a call documentation form that each volunteer completes on each call.  During the call, the volunteer notifies the caller that someone may be contacting them for a satisfaction survey, and that we'd like to provide them with written information on the issue they called about and check back with them to see how they are doing.  Only about 5% of our callers have refused this and we just document this statistic along with our other stuff.

We have the following on the bottom of our website and brochure "The information provided through the BEPS Website and Comfort Line is general lactation advice designed to help you breastfeed your baby.  You should not rely on the information as a substitute for medical or health care advice, or for diagnosis or treatment purposes.  Consult your physician or pediatrician about medical or health - related questions, and do not await a response from our specialists before such consultation."

I don't think that this wholly reduces our liability but between this and our volunteers referring anything out of the ordinary - I am really not that concerned.  Maybe that's naive, but I would hope and pray we would be looked upon as providing a necessary service to our community.

We have a pretty small La Leche League in our community (Bakersfield) - and I believe only one leader working at this time.  She is a member of our BF Promotion Coalition (partners/advisors in this project) but to be honest I haven't had a lot of contact with her.  We do have her support group/meeting information listed (along with the three (!) others in our community) (can you believe it only three! - I applied to Kaiser Permanente about a month ago to start up some additional ones and they declined! ahhh!) on our brochures, etc.  She is very supportive of this project and wrote us a letter of support way back in our proposal submission days, but she's only one person and I can totally empathize with the lack of time to be everywhere etc.  I would love to have a stronger relationship with LLL here in Bakersfield and that's something I really need to pursue.

But this is why we are so needed in this area!  We have six birthing hospitals (I forgot one in my last message), approx. 11,000 births yearly, three IBCLCs and four support groups - Not great ratios at all!

Our project is funded through Proposition 10 - the tobacco tax imposed on cigarettes here in California.  I recently attended (and presented!) at the State MCH conference in San Francisco where I sat on a moderated panel with Dr. Bruce Smith on BF projects funded through Prop 10.  When Dr. Smith initially was investigating agencies who had received $$ for bf projects to sit on this panel, he was only able to locate a handful - now there are something like 40 in our state!  I think this is just fantastic and I hope that each is able to turn the curve (even just a little bit each!) in increasing the amount of time women are breastfeeding.  So those of you in California - next time you see a smoker - feel free to go over and thank him on behalf of bf infants! (okay - a little controversial - but I like to stir things up!)

Just as an FYI, we've applied to our county Prop 10 for a "Maternal Labor & Post-Partum Education and Support Project" which would train 14 women to become DONA-certified Doulas and provide doula services to women in our community on a sliding scale basis.  The most exciting aspects of this project would be that 1) Penny Simkin has tentatively agreed to provide the training (!); 2) Dr. Marshall Klaus & Dr. Jack Newman have provided letters of support (thank you, thank you!); 3) 14 hours of postpartum services (read: breastfeeding support!!) would be included with each birth 'assignment'!  Send your prayers and warm thoughts to us (and especially our local Children and Families/Prop 10 Commission!) that we will be able to provide this service to our community!!  I really see this new project as an enhancement of our existing bf project- our in-hospital bf rate is 35%!! - we'll (hopefully!) find out in July whether we're funded.

So thanks for letting me ramble on... I just am so excited about what we're doing and the results we're seeing (already!).  Thanks for all the education I receive from all of you on LactNet - this is a fantastic resource!  (If only I could keep up with all the emails!)

Amy Smith
Healthy Mothers, Healthy Babies of Kern County
Bakersfield, CA
Mom to Christopher (6) & Charlotte (14 mos) (who goes to work with Mommy!)

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