Advancing Breastfeeding in Colorado – and at CHI

Update: January 13, 2021

This blog notes that the Advancing Breastfeeding in Colorado initiative (ABC) is entering its final six months of guaranteed funding. On Friday, January 8, the CCPD Grants Program Review Committee (see below) convened and approved two additional years of funding for select grantees, and ABC was one of the grantees selected for a funding extension. Stay tuned for more on the future of ABC as the team plans to extend its work into 2023.

The Colorado Health Institute (CHI) is proud to announce that Denver Public Health has officially recognized our office as a breastfeeding-friendly workplace. Despite a national “baby bust” during the pandemic, the CHI team is experiencing a baby boom, with four new arrivals in the second half of 2020 and one on the way. The breastfeeding-friendly recognition is well-timed for our new parents and parents-to-be. (Or it will be, whenever we can all work together again in person.)

As part of the Advancing Breastfeeding in Colorado (ABC) initiative, which CHI coordinates, local public health agencies like Denver Public Health recognize organizations across the Denver metro area as breastfeeding- or lactation-friendly. While CHI already had a policy in place to protect lactation time for new parents, our office didn’t have a designated lactation space and after working with ABC, we decided it was time we walked the walk.

If “breastfeeding-friendly” is a new term for you, a quick overview:

  • Employers and worksites can achieve breastfeeding-friendly recognition for implementing a lactation support policy. These policies apply to employees and often to visitors or customers.
  • Written lactation support policies should describe accommodations for both time and space to breastfeed or express milk. Employees should experience few or no barriers to scheduling breaks during the workday and should be able to access a designated private space that is not a restroom. Ideally, this space will offer a comfortable place to sit and include a sink and a refrigerator.
  • These requirements align with Colorado’s Workplace Accommodations for Nursing Mothers Act, which applies to any employer.

Kids of a certain era may associate the acronym “BFF” with being “best friends forever”but members of the ABC team use it to refer to sites that have officially become “breastfeeding-friendly.” Both should give you the warm fuzzies.

CHI’s new recognition gave us a chance to celebrate. It is also a good opportunity to share the exciting work being accomplished by the hardworking members of ABC.

The ABCs of ABC

Born out of the Metro Denver Partnership for Health and funded for three years through Colorado’s Cancer, Cardiovascular, and Pulmonary Disease (CCPD) Grants Program, the ABC initiative is reducing barriers to breastfeeding and promoting BFF environments. ABC has another six months of guaranteed funding to continue this work.

ABC’s partnering local public health agencies Boulder, Denver, Jefferson, and Tri-County have dedicated staff who work with organizations in their respective jurisdictions. An additional ABC team member, who is based in Durango, provides statewide support outside of those counties. CHI convenes the ABC group and provides policy insights, thought partnership, and evaluation support.

These partners, along with local coalitions and stakeholders, work to support parents and families especially those with less access to lactation resources and limited support at their jobs or in their communities.

One avenue to achieving ABC’s goals is supporting organizations on the pathway to recognition as BFF. ABC staff at local public health agencies focus their recognition efforts on four sectors: employers and worksites, public spaces, child care providers, and medical offices. Recognition requirements differ across the sectors, but ABC staff provide training, technical assistance, grant funds, and supportive materials to each site. Since its inception in July 2018, the partnership has collectively recognized over 150 sites as BFF.

The ABC team also works to create a seamless system of culturally competent lactation support and expand access to lactation professionals. ABC partners provide regional training, networking opportunities, and support for local breastfeeding coalitions. The work often serves as a bridge between local coalitions and the statewide Colorado Breastfeeding Coalition.        

Why Breastfeeding?

CCPD grant programs like ABC aim to reduce the burden of chronic disease across the state.  Two facts guided the development of ABC: first, the fact that the burden of chronic disease is disproportionately shouldered by low-income families, people of color, and members of Indigenous communities due to systemic racism, unsupportive environments, and lack of culturally relevant care; and second, the fact that increasing breastfeeding initiation and duration rates can have long-term positive impacts on addressing chronic disease.

Breastfeeding rates in Colorado are, on average, slightly better than national rates and are on target to meet national goals. But breastfeeding is less common among some populations, especially those have historically been under-resourced. People of color and people with lower incomes breastfeed at lower rates, especially at the three- and six-month marks. This is due to a range of factors, including lack of support for breastfeeding in the workplace. These breastfeeding inequities can have lifelong consequences for health.

ABC works to address barriers to breastfeeding by supporting environments and policy changes that promote breastfeeding as a public health priority for all Colorado communities. Our team focuses on supporting organizations that employ low-income workers, who often face the greatest barriers, and communities in greatest need of the resources to lead breastfeeding promotion.

Making an Impact

As ABC moves into the final six months of its three-year CCPD grant, the cross-agency initiative has made significant progress toward its goals.

In addition to successfully recognizing dozens of sites as BFF, the team has made great strides in improving the statewide system for lactation support. In the first two years of the partnership, ABC supported professional lactation education for over 50 individuals, including people who work in health care, public health, and child care. In addition, hundreds of community members have participated in agency-sponsored trainings and support sessions.

In this third year, ABC is focusing on training efforts that strengthen lactation education in under-resourced communities and support more targeted local solutions. For one, the ABC team, in collaboration with partners, is connecting with the national organization Reaching Our Sisters Everywhere (ROSE) about supporting a peer counselor training for Black and African American communities.

In addition, ABC offers support for communities outside of the Denver metro area through its “seed money” program and associated technical assistance. To date, ABC has awarded 31 grants for seed money for a variety of activities, ranging from coordinating trainings to encouraging growth in local breastfeeding coalitions. The hope is that these seeds of support will bear fruit throughout the state of Colorado.

The Road Ahead

Lactation room with a couch, chair, low table and sink
CHI’s new designated lactation room at our 1999 Broadway office.

In the coming months, the ABC partnership is getting serious about sustainability determining which activities to continue and how to transition them to local leaders and statewide entities. The group is also thinking about new areas of focus beyond the third year, whether or not it has dedicated state funding.

Local public health agencies will continue to partner and likely pivot to focus more on upstream policy choices that affect not only the right to breastfeed, but the likelihood of positive health outcomes for babies and families. The new paid family and medical leave program passed by Colorado voters in November is one example.

Against the backdrop of an ongoing pandemic, an economic downturn, and daunting challenges to many safety net systems and supports, the work of ABC is more important than ever. CHI is grateful to work with the dedicated public health staff who advance this work across our state, promoting health and allowing growing families to thrive.

It’s unclear when CHI staff will be working together from our new office, or when we will be able to welcome colleagues and community members to our space. But we are excited to have a warm, inviting, and fully equipped lactation space for our partners, colleagues, and guests.

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