Implementing the Business Case for Breastfeeding across a multi-city region: One approach to the health reform mandate and beyond

Introduction: Breastfeeding benefits the health of babies and mothers, yet many mothers stop breastfeeding when they return to work post-childbirth. Virginia's 2009 statistics indicated the need for breastfeeding support throughout baby's first year, consistent with the 2010 Patient Protection and Affordable Care Act. Funded by the Virginia Department of Health, the Consortium for Infant and Child Health (CINCH) promotes the Business Case for Breastfeeding (BC4BF) using guidelines and materials from the Office of Women's Health, published by the Health Resources and Services Administration. Three main objectives guide the use of BC4BF to increase breastfeeding in South Hampton Roads. 1: Identify 20 businesses and engage them in BC4BF. 2: Implement BC4BF among 10 businesses, documenting policy and environmental changes. 3: Assess the feasibility of integrating BC4BF into the business infrastructure. Methods and Results: CINCH invited over 20 businesses with female employees of childbearing age to participate. The willingness of each company to implement changes and manage a sustained breastfeeding program is assessed, with consideration for operational and human resource impacts. Businesses are encouraged to start with the most feasible elements of the four components of lactation support, then to expand over time. The Transtheoretical Model of Behavior Change was adapted to assess organizational changes. CDC's CHANGE Tool was adapted to assess worksite policy and physical and social environment changes. Program evaluation results will reveal information regarding engagement of businesses in BC4BF implementation, movement across stages of change, and status of lactation support programs including written policies and/or environmental improvements.