9 Steps to

Looking for resources and advice from the field to help your health center or community clinic implement breastfeeding-friendly guidelines in your clinic or health center?

The 9 Steps To Breastfeeding Friendly: Guidelines for Community Health Centers and Outpatient Care Settings (PDF) was designed just for you.

The California Breastfeeding Coalition (CBC), California Dept. of Public Health and California WIC Association have collaborated on resources to support your success. If you have additional recommendations to add, please contact us or your WIC Regional Breastfeeding Liaison (RBL).

We developed the 9 Steps Guidelines to support community health centers and outpatient care settings to:

  • successfully implement practices and policies that protect, promote and support lactation; and
  • provide a framework for creating and sustaining a community-based, universally accessible, quality care and support system for breastfeeding mothers and their families.

Chest/breastfeeding and human milk feeding is universally recognized as the ideal source of nutrition for growth and development for most infants and children. Human milk provides newborns and infants with nutrients in the most natural, bio-available forms.

The health benefits of lactation, chest/breastfeeding, and human milk feeding apply to both mothers and infants, and therefore to the community at large. The longer an infant is breastfed, the better the results for infants.

According to state data collected from 2018-2020, more than 94 percent of California mothers reported having ever breastfed. But by 3 months, only 33.2 percent of infants were exclusively breastfed. Both the Centers for Disease Control (CDC) and American Academy of Pediatrics (AAP) recommend exclusive breastfeeding to 6 months of age. The AAP recommends continued human milk feeding to 2 years of age and beyond, as long as mutually desired by both mother and child.

In the U.S. Surgeon General’s Call to Action to Support Breastfeeding, the following major barriers to breastfeeding have been identified:

  • lack of knowledge about risks associated with not breastfeeding
  • social norm of bottle feeding
  • poor family and social support
  • embarrassment and social disapproval of breastfeeding in public
  • lactation problems
  • lack of maternity care and return to employment
  • hospital policies and clinical practices where a low priority is given to breastfeeding education and support

Though community health clinics, health centers and doctors’ offices cannot mitigate all barriers to lactation and human milk feeding, you carry great influence with families and the choices they make. Specifically, families say support and encouragement from health care providers can make a difference in their ability to initiate and maintain lactation, and shifting cultural norms in favor of supporting and discussing breastfeeding.

The department of public health has additional online resources to equip you with information, so you can confidently join us in supporting lactation, human milk feeding, and families — for the health of our mothers, our infants, and our communities. 

The case studies below describe the great strides taken by three California community health centers to fully support moms, babies, and their families to initiate and continue breastfeeding: