Application for Recognition as a
Breastfeeding Friendly Health Department:
Step 7
To apply for completion of Step 7:
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 7: Support mothers in initiating and maintaining breastfeeding up to twelve
months and beyond
A. Educate parents and community partners about the importance of exclusive breastfeeding and the difficulty of
reversing the decision not to breastfeed
Describe how you ensure
that relevant health
department staff are able to
provide this education
B. Ensure that mothers know how to access timely support and resources, express their milk, and obtain a breast
pump when appropriate, to manage separation from their babies
Attach instruction sheet or
describe how this education
is provided
C. Work with local providers to ensure they are aware of resources that inform them about medication compatibility
with breastfeeding
Attach resource(s) used and
list one or more providers
you are working with
D. Develop a formal referral system for communicating mother's breastfeeding progress to staff as she moves from
hospital to community/public health programs
Attach referral process document(s)
E. Inform mothers of state and federal breastfeeding laws
Attach document(s) you provide to mothers about the law
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
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