Application for Recognition as a
Breastfeeding Friendly Health Department:
Step 8
To apply for completion of Step 8:
Complete this form electronically using Adobe Acrobat or Adobe Reader 9.1 or later. Adobe Reader is a free
application that can be downloaded from the internet. Save the form to your computer and submit it by email as an
attachment to [email protected], along with any required supplemental documents (see below), a cover sheet,
and applications for the other steps your health department has completed. See the web page or the cover sheet for
more details about the application process.
Note: Any place you are asked to attach a document or enter text it is acceptable to provide a link to a current web
page instead. An attachment is also acceptable as an alternative to entering text directly on this form.
Step 8: Through community partners, encourage local public places to provide a
breastfeeding friendly environment for families
A. Work with local public places such as libraries and community centers to provide a private space to breastfeed
and/or express milk
List at least two places you
have worked with or are
currently working with
B. Encourage the facility to educate staff on acceptable vs. unacceptable behaviors and responses towards
breastfeeding women
Describe or provide an
example of how you
encourage the facilities you
work with to educate staff on
acceptable behaviors
towards breastfeeding
women (e.g. attach
education sheet)
C. Encourage the facility to display signage identifying it as breastfeeding friendly
Provide an example of
signage used (image or
narrative)
Office Use:
Minnesota Department of Health
Office of Statewide Health Improvement Initiatives
P.O. Box 64882, St. Paul MN 55164-0882
www.health.mn.state.us/divs/oshii
Received on
Filed on
Site ID