THE TENNESSEE BREASTFEEDING HOTLINE (TBHL)
Goal
To foster the healthy development of children by
promoting and supporting the practice of
breastfeeding in Tennessee
THE TENNESSEE BREASTFEEDING HOTLINE (TBHL)
Service Recipients
Nursing mothers, their families and partners,
expectant parents, and health care providers in
Tennessee.
THE TENNESSEE BREASTFEEDING HOTLINE (TBHL)
LeBonheur received the award in September of 2013
Soft Launch was implemented November 2013
Statewide January 2014
THE TENNESSEE BREASTFEEDING HOTLINE (TBHL)
Project Manager / Coordinator: Helen Scott RN, IBCLC, RLC
Project Evaluator Dr. Christina Underhill
Director: Sandra Madubuonwu MSN, CLC, RN
Consultants and Counselors
Crystal Higgins, MS, CLC
Victoria Roselli, BS, IBCLC, RLC
Lori Jill Lewis, BSN,CLC,RN
Elizabeth Pletz, BSN,CLC,RN
Angela Rainey BSN ,CLC,RN
Pam Avant BSN,IBCLC,RN
Creedon Ryan, BSN, CLC,RN
Lakisha Windle, RN, CLC
Bridgette Reed, BA, CLC
Julie Bridger, BSN, CLC,RN
THE TBHL TEAM
OPERATION OF THE HOTLINE
Staffing
One on one meetings
Answering the phone
.
Managing software
programs
Group Staff Meetings
Management Meeting
Follow-ups
Communications with the
State
Call Reports
Reports
Feedback on call reports
CAB meetings
CONTINUOUS QUALITY MEASURES
Use of AAP Guideline
Monitored call with Lactation Counselor
Follow-up calls to participants
Conference Call meetings
Feedback to Counselors
Transcript Review
Professional staff credentialing and staff training
Community Advisory Board
TBHL OVERVIEW AND PROGRESS
Call volume has progressively increased since the
implementation of the project in November of 2013
CALL VOLUME NOVEMBER 1,2013 –AUGUST 3 1, 2014
JUNE CALL VOLUME BY DAY OF THE WEEK
JULY CALL VOLUME BY DAY OF THE WEEK
AUGUST CALL VOLUME BY DAY OF THE WEEK
RELATIONSHIP
. Caller’s Relationship to Mother
Caller's
Relationship to
Mother
November
December
January
February
March
April
May
June
Percentage
Family or
household
member
Self
Spouse or
partner
Undisclosed
Other
TOTALS:
0
0
0
4
3
3
3
4
1.4%
2
0
14
3
20
2
135
7
172
7
204
4
236
11
263
6
75.8%
2.9%
2
0
4
25
10
52
90
1
113
31
3
180
19
7
208
31
11
253
26
7
283
10
4
287
16.9%
3.1%
100.0%
MOTHER’S RACE
Race of Mother
April
May
June
American Indian or
Alaskan Native
Asian
Black
Mixed
Other
White
Undisclosed
TOTALS:
2
2
29
0
3
107
110
253
3
4
36
2
5
125
108
283
5
0
30
1
5
141
105
287
3rd Quarter
Totals
Percentages
10
6
95
3
13
373
323
823
1.2%
0.7%
11.5%
0.4%
1.6%
45.3%
39.2%
100%
Top Ten Reasons
Primary Reason for Calling
Total Calls
Percentage
Other
Not making enough milk
Medications & breastfeeding
Breast engorgement
Breast/nipple pain
Baby refusing to nurse
Sore nipples
Breast pumps/rental
Baby spitting up
Overactive letdown/too much milk
172
117
110
94
60
49
49
25
17
24
24.0%
16.3%
15.3%
13.1%
8.4%
6.8%
6.8%
3.5%
2.4%
3.3%
TOTALS:
717
100.0%
Calls to the Tennessee Breastfeeding Hotline
By County of Caller
October 2013 through June 2014
Pickett
Robertson
Macon Clay
Hancock
Stewart
Sullivan
Johnson
Sumner
Montgomery
CampbellClaiborne
Fentress
Hawkins
Trousdale
Scott
Jackson
Lake
Overton
Carter
Obion Weakley Henry
Union Grainger
Washington
Smith
Houston Cheatham
Hamblen
Davidson Wilson
Morgan
Greene
Dickson
Putnam
Anderson
Benton
Jefferson
Unicoi
Dyer
Humphreys
Cumberland
Gibson Carroll
Knox
Dekalb
Cocke
White
Williamson
Rutherford
Roane
Crockett
Cannon
Sevier
Hickman
Lauderdale
Warren
Decatur
Loudon
Madison
Van Buren Rhea
Blount
Maury
Henderson Perry
Haywood
Bledsoe
Bedford
Lewis
Tipton
Meigs
Coffee
Monroe
Marshall
Grundy
Chester
Mcminn
Sequatchie
Fayette
Moore
WayneLawrenceGiles
Hardeman
Hardin
Lincoln Franklin MarionHamilton Bradley
Shelby
Mcnairy
Polk
0
1 to 50
51 to 100
101 to 200
201 to 500
501 to 1500
TOP 10 COUNTIES
Shelby
353
35.5%
Davidson
Hamilton
Rutherford
Williamson
Knox
Wilson
Sumner
Sullivan
Montgomery
263
93
92
54
40
33
30
18
18
26.5%
9.4%
9.3%
5.4%
4.0%
3.3%
3.0%
1.8%
1.8%
TOTALS:
994
100.0%
FOLLOW UP
Callers Who are Still Breastfeeding at
each Follow-up
Annual Totals
Number
Percentage
24 hour follow-up
291 of 302
96.3%
4 week follow-up
158 of 189
83.6%
8 week follow-up
70 of 76
92.1%
12 week follow-up
49 of 58
84.5%
FOLLOW UP
Satisfied or Very Satisfied with Services
at each Follow-up
Number
Percentage
24 hour follow-up
297 of 302
98.3%
4 week follow-up
180 of 189
95.2%
8 week follow-up
70 of 76
92.1%
12 week follow-up
55 of 58
94.8%
FOLLOW UP
Increase in Confidence/Comfort Level
with Breastfeeding at each Follow-up
Annual Totals
Number
Percentage
24 hour follow-up
255 of 302
84.4%
4 week follow-up
8 week follow-up
12 week follow-up
170 of 189
65 of 76
49 of 58
89.9%
85.5%
84.4%
OUTCOME MEASURES
OUTCOME MEASURES
STRENGTHS OF THE PROGRAM
 Dedicated full time and PRN employees
 Participant could call from any part of the
state.
 Availability of the program 24hours a day
 Use of experts in the area of breastfeeding
 Availability of Breastfeeding resources to all
 Follow up at different intervals to ensure
that participants needs were met
STRENGTHS OF THE PROGRAM




Comprehensive and easily accessible data base system.
Reliable routing telephone system
Outcomes are measured to enhance and inform practice.
Success of the project have attracted other states to
inquire about how to implement the program in their
state
 Increased Breastfeeding awareness for the entire state.
 Flexibility for staff scheduling
CHALLENGES
 Creating a clear, informative greeting message for
callers
 Learning the resources available for the State of
Tennessee
 Lack of local lactation counselors for non-WIC
participants
 Crank calls have increased, being an issue at night
and on weekends.
Our resource list began with about 150 WIC and Health Departments
offices across the State. We now have over 450 resources . thing


Hospitals
Bi Centers
Pediatricians
Hospitals
Birthing Centers
Pediatricians
Breast Pump and supplies
National Breastfeeding
Helpline
WIC / Health Dept.

Pump and supplies

National Breastfeeding














IBCLCs by Location
Breastfeeding Coalitions
Womens Health. Gov
TN BF laws
Medications
Kellymom
Le Leche League
LAUREN ROBINSON AND HER SON (CAB MEMBER )
l
LISA FISHER AND TEAM MEMBERS