Population of Okeechobee county approximately 35,910 increases by approximately 15,000 in the winter months. The median

1. Demographics • Population of Okeechobee county approximately 35,910 increases by approximately 15,000 in the winter months. • The median income is $26,129 • Approximately 20% of the residents in Okeechobee live below the poverty level. • Beef, dairy and citrus are the leading industries.

3. Demographics • The racial make-up of the county is as follows: 70% white, 20% Hispanic, 8%Black, and 2% other. • The WIC racial population is 49.9%white, 42.76% Hispanic, 6.62 black, and 0.65% other.

4. Background on Breastfeeding Program • Goal to provide more breastfeeding support for clients. • OCHD has an IBCLC in the WIC clinic to assist the Breastfeeding Coordinator. Funding provided by The Healthy Start Coalition. • The OCHD provides all of the support services for the lactation consultant position.

5. Healthy Start Coalition • Enacted in 1991 • 32 coalitions state-wide • Goal to establish a system which guarantees all women have access to prenatal care and that all infants have access to services that promote normal growth and development.

6. Barriers • No public transportation. • No hospital that provides obstetric services. • Language • Insufficient breastfeeding knowledge in the medical community

7. Solutions • We have one taxi service that speaks Spanish. • Inform client of resources available at delivering hospitals. • OCHD partnered with the local community college to provide Spanish classes to all staff. • Provided reference books such as Medications and Mother’s Milk to Peds & OB clinics. Also invited health care providers to attend the 18 hour course.

8. Reasons for success • The Bilingual Breastfeeding coordinator usually has first contact with clients applying for WIC. • Healthy start has a bilingual care coordinator that works with Hispanics and migrants. • All clinics who serve the Hispanic population have bilingual staff available

9. Reasons for success a. All clients receive assistance completing required forms. b. All literature is available in Spanish. c. DCF, East Coast Migrant day care, or WIC are resources for current addresses. d. OCHD has an in-house care provider (ARNP) if clients have breastfeeding complications that need an RX or referral.

10. Reasons for Success • The Healthy Start care coordinators and the lactation consultant make home visits. • Breast pumps that do not require eletricity are available. • Electric hospital grade pumps are available. Also one at the high school. • Breast pumps can be delivered and picked up.

11. Reasons for Success • Breastfeeding is reinforced at every visit. • All WIC staff have had training. At least an 18 hour course. • Some of the OCHD staff and H.S. care coordinators have had the 18 course. • The LC also does parenting classes and discusses breastfeeding. • The Breastfeeding Coordinator is well known and has a good relationship with the Hispanic community.

12. Reasons for Success • Recognition program for moms who breastfeed for an extended period. • Referrals are received from other agencies. • Developing a breastfeeding support group locally.

13. Lessons Learned • The most important thing is you need time to spend with clients. • A private room for assisting breastfeeding moms. • A very valuable asset having Healthy Start staff, WIC staff and an LC all housed together. • You need to have a good relationship with the OB providers and pediatricians.

14. Lessons learned • Need a good referral system • More community awareness and involvement. • The more staff available the better • Available funds for training of staff and for materials