DOVER (May 17, 2022) – The Division of Public Health (DPH) is providing guidance to families struggling to find formula due to a shortage caused by a supply chain issues, including avoiding taking certain measures that could be harmful to their infant’s health.

DPH sent out a letter from U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration’s Maternal and Child Health Bureau to families and maternal child health stakeholders, offering individuals information on how to safely navigate the shortages. 

Parents and caregivers are offered the following guidance:   

•  Talk to your doctor: Families should consult their pediatrician to discuss the best options for their child. Doctors can provide guidance on comparable formula and specialized formula to meet their babies’ medical and nutrition needs. 
• Consider a substitute formula: For most babies, it is OK to use a similar version of their formula if their regular brand of formula is not currently available. Talk with your baby’s pediatrician about alternatives.  
• Check the manufacture’s site online for formula availability before going to a store to purchase.    

DPH reminds parents/guardians: 

• Do not make or use homemade formula: Per the American Academy of Pediatrics (AAP) and Food and Drug Administration (FDA), homemade formulas often lack or have inadequate amounts of critical nutrients vital for a babies growth and development and in some cases can cause infants to be hospitalized due to low calcium. 
• Never dilute formula: Watering down infant formula can be dangerous and even life-threatening, leading to a serious nutritional deficit and health issues. 
• Consider a substitute formula: For most babies, if their regular brand of formula is not currently available, using a similar version of their formula is ok. Talk with your baby’s pediatrician about alternatives.  
• If not receiving breast milk, formula should be used until your baby turns 1 year old, but if your child is over six months you can start to supplement nutrition with some solids. Talk to your pediatrician about introducing some solids like fortified cereal, mashed bananas and pureed poultry and beans. 
• Talk to your doctor: Families should consult their pediatrician to discuss the best options for their child. Doctors can provide guidance on comparable formula and specialized formula to meet their babies’ medical and nutrition needs.  
• Breastfeed your child: When possible, breastfeeding is the healthiest option for children under age 1. 
• For parents who are breastfeeding or need additional support, they may want to consider a lactation consultant or support groups, or seek assistance to access a breast pump at a low cost through your insurance provider, Medicaid, or WIC to assist with milk supply. There are also breast milk banks that properly store, test and distribute donated mothers’ milk to meet the specific needs of infants for whom human milk is prescribed by physicians.  The Delaware WIC program offers breastfeeding assistance to new mothers, including peer counselors, lactation consultants and manual pumps. Details on WIC’s breastfeeding programs can be found here. 

DPH has also taken the following steps to help parents and caregivers as the supply chain issues get resolved nationwide: 

• WIC recipients have been asked to return any unused formula to the Food Bank of Delaware or another state agency food pantries.   
• WIC recipients also were granted a waiver to substitute formula this winter when supply chain issues that were made worse by a recall first emerged. A chart of formula alternatives was created to help parents and caregivers select the right formula for their child.   
• Parents who are breastfeeding or need additional support may want to consider a lactation consultant or support groups, or seek assistance to access a breast pump at a low cost through their insurance provider, Medicaid, or WIC to assist with milk supply. The Delaware WIC program offers breastfeeding assistance to new mothers, including peer counselors, lactation consultants and manual pumps. Details on WIC’s breastfeeding programs can be found here.   
• DPH reminds parents that state and community resources that could be helpful during this time are available, such as WIC, SNAP, or TANF to help with the cost of buying formula or to find other infant supplies through local food banks including the Food Bank of Delaware. DPH also offers a breastfeeding guide for mothers who want to find support or learn more about breastfeeding.

Several birth hospitals in Delaware also offer breastfeeding support and parent education. Individuals should check with their local hospital to see what services are offered.   

Delawareans are encouraged to visit dethrives.com for up-to-date information on Delaware’s response to the infant formula supply chain issues, call 211 for community resources and services near you, or follow DEThrives and DPH on Facebook and Instagram.     

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Anyone who is deaf, hard of hearing, Deaf-Blind or speech disabled can contact DPH by dialing 711 first using specialized devices (i.e., TTY, TeleBraille, voice devices). The 711 service is free and to learn more about how it works, please visit delawarerelay.com.   

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. 

Public Health asks OB/GYNs to screen pregnant women for substance use disorder

DOVER – Delaware and the nation are struggling with an addiction epidemic, a fact that is well known. Less well known is that the addiction epidemic is impacting pregnant women and their infants in increasing numbers. In 2016, there were 431 reports of substance exposed infants to the Department of Services for Children, Youth and Their Families, a sharp increase from the previous year.

The two most common substances found at birth in Delaware are marijuana and opioids, both of which are tied to either short and/or long term negative consequences for the infant. Alcohol exposure, which has the most well-documented long term negative impacts on an infant, is virtually impossible to detect immediately following birth but remains a serious problem throughout the country.

Responding to input from OB/GYN providers, the Division of Public Health (DPH) today announced new guidance and educational materials on the dangers of substance abuse while pregnant, and how to screen pregnant women for potential addiction and connect them with treatment. The materials will be available starting today at www.helpisherede.com/Health-Care-Providers#obgyn-resources.

“Pregnant women often do not realize the extent to which even minimal alcohol and drug use can harm their baby,” said Dr. Karyl Rattay, DPH director. “We also know that women struggling with addiction are less likely to access prenatal care and are significantly more likely to have an unplanned pregnancy. We want to work with the medical and treatment communities to increase awareness about the dangers of substance use while pregnant and connect those struggling with addiction to treatment.”

Delaware’s law, the Medical Practice Act, requires certified medical providers to give written, verbal and posted warnings to pregnant women regarding possible problems, complications, and injuries to them and/or to the fetus from consuming or using alcohol or cocaine, marijuana, heroin, and other narcotics during pregnancy (Delaware Code, Title 24, Chapter 17 (Medical Practice Act), Subchapter V, §1769A).

Under House Concurrent Resolution 44 – sponsored by Representative Ruth Briggs King and Senator Ernie Lopez – the General Assembly has designated September 17 – 23 as “Awareness Week for the Prevention, Recognition, and Treatment of Prenatal Substance Exposure in Infants and to Support Healthy Families in Delaware.”

“Little things have a big impact on unborn and newborn infants. We must protect the health and welfare of the most innocent and vulnerable to enable them to have a healthy outcome,” said Rep. Briggs King. “Delaware is faced with many challenges in our war on heroin and opioid addictions. Families and their futures depend on us to be leaders; therefore, it is imperative that we develop and deploy a strategy. When we know better, we do better. The sooner we share, learn, and act, the faster we see positive results.”

Delaware first began to address this issue last year. In 2016, it was one of the states selected for Substance Exposed Infants In-Depth Technical Assistance (SEI IDTA), funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, and the Administration on Children, Youth and Families, and provided by the National Center on Substance Abuse and Child Welfare. The Delaware Child Health Protection Accountability Commission, Department of Health and Social Services, Department of Services for Children, Youth and their Families, March of Dimes, Delaware Healthy Mother and Infant Consortium (DHMIC), Fetal Alcohol Task Force, Connections, medical providers, and many others have begun work to:

• Survey birth hospitals and obstetricians and gynecologists on their experiences and needs to help them address the addiction epidemic.
• Increase screening of reproductive age women who may be at risk for substance abuse addiction, and increase links to treatment and home visiting services.
• Educate physicians on the signs and symptoms of addiction in pregnant patients, and how to refer patients to treatment.
• Reduce stigma around maternal substance use, and highlight the role of addiction as a chronic disease and the importance of connecting families to support, not punitive measures.
• Develop a system where infants born substance exposed and their families receive the medical treatments and supports they need as part of the federally-required “Plan of Safe Care” process. The revised federal rule requires states to address the health and substance use disorder treatment needs of the infant and family.
• Link to the Delaware Contraception Access Now (Delaware CAN) program to help women get access to effective contraception immediately postpartum.

“The Child Protection Accountability Commission Committee on Substance Exposed Infants Task Force sought the federally funded In-Depth Technical Assistance in response to the addiction epidemic and the impact it is having on our infants and families in Delaware,” said Jennifer Donahue, Esq. and co-chair of the SEI IDTA with Public Health. “We are now in the process of building a system of care that is better equipped to help pregnant women struggling with addiction, and, following the birth, to ensure that mothers and infants have the services, treatment, and supports they need to thrive as a family unit.”

Added Dr. David Paul, DHMIC Chairman and Christiana Care Heath System Chair of Pediatrics, “We have seen a sharp increase in newborns struggling with neonatal abstinence syndrome and have worked hard to standardize our medical care, minimize length of hospital stay and assure safe transition from hospital to home in this population of infants. By engaging multiple stakeholders throughout the state, we are making great strides in improving outcomes and assuring that babies with neonatal abstinence syndrome start their life as safely and healthy as possible.”

“Like many states across the nation, Delaware has experienced a sharp increase in the number of babies who have been born substance exposed,” said Trenee Parker, deputy director of the Division of Family Services in Delaware’s Department of Services for Children, Youth and Their Families. “We are more committed than ever to address the varied needs of this vulnerable population and to continue to work collaboratively with our system partners, advocates, and families to ensure healthy outcomes for Delaware’s children and their families.”

To find the screening materials and more information about substance use disorders, addiction, and where to find treatment, visit the Help is Here website at www.helpisherede.com, or call DHSS’ 24/7 Crisis Services Hotline at 1-800-652-2929 in New Castle County, or 1-800-345-6785 in Kent and Sussex counties. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 9-1-1 immediately.

Data indicates that the unplanned pregnancy rate of women struggling with addiction is very high – up to 90 percent in one study. Through the Delaware CAN initiative, any woman who wants access to effective contraception can get it for free. To find Delaware CAN participating providers, visit www.upstream.org/delawarecan or call DPH’s Family Planning office at 302-744-4552.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

DOVER – Although breastfeeding is a natural process, many moms need help, and have a lot of questions. Other moms who are currently breastfeeding or have in the past, along with professionals who have experience with promoting and consulting on lactation practices, can be great resources. The Division of Public Health (DPH) is bringing these groups together in one place to support breastfeeding and its many benefits.

Registration is now open for the DPH WIC Program’s 2017 WIC World Breastfeeding Celebration. The event will be held at Dover Downs Conference Center in Dover on Aug. 3, 2017, to commemorate World Breastfeeding Week, which is Aug. 1 – 7, 2017. The conference theme is “Sustaining Breastfeeding Together.”

This daylong conference brings together breastfeeding partners from across the state as well as national speakers and community members to celebrate the many benefits breastfeeding offers mom and baby. Sessions include, The Role of Implicit Bias in Breastfeeding Disparities, Grassroots Innovation and Best Practices, Breastfeeding Support for African-American Families, Promoting, Protecting and Preserving Breastfeeding, and Neonatal Abstinence Syndrome-Breastfeeding Support for Mothers and Babies.

The conference will be held from 9:00 a.m. to 4:00 p.m., with registration starting at 8:30 a.m. Registration is free and will remain open through the day of the event. For more information or to register, contact Ida Lewis at 302-741-2900 or via email at Ida.Lewis@delaware.gov.

The WIC Breastfeeding Celebration also serves to highlight August as National Breastfeeding Month. “Breastfeeding is important for so many reasons,” said DPH Director Dr. Karyl Rattay. “It starts infants on a healthy life course because it is the optimal nutrition for infants and protects them from many illnesses and diseases.”

Breastfeeding protects babies from sudden infant death syndrome (SIDS), diarrhea, ear infections, pneumonia, allergies, and asthma. Babies who are breastfed exclusively for six months are less likely to become obese. The benefits of breastfeeding are dose-related; the more breast milk a baby receives, the greater the protection for both mother and baby. Mothers who breastfeed have less risk of breast and ovarian cancers, and lose pregnancy weight faster.

Major medical organizations including the American Academy of Pediatrics, World Health Organization, Centers for Disease Control and Prevention, among others, recommend that babies receive only breast milk for the first six months of life and that breastfeeding continue for at least the baby’s first year, and for as long as mom and baby wish. Of Delaware infants born in 2013, 18.9 percent were breastfed exclusively through six months, compared to 22.3 percent nationally and the Healthy People 2020 goal of 25.5 percent. At one year of age, 24.5 percent of Delaware infants born in 2013 were breastfed, compared to 30.7 percent nationally and the Healthy People 2020 goal of 34.1 percent.

While still below the national average, Delaware continues to make progress in breastfeeding support due to the collaboration of health systems, businesses, state agencies and private citizens.

• Breastfeeding support in the workplace, including flexible break time and private space to pump, has been legislatively mandated for all employers and employees in the state.
• Delaware child care regulations require breastfeeding support in both center and family-based care.
• In 2015, Delaware became the third state in the nation to eliminate formula gift bags in all hospitals.
• Delaware ranks second in the nation in maternity practices supportive of infant nutrition and care, as measured by the CDC’s mPINC survey. This is due to the extensive efforts of labor and delivery hospitals on breastfeeding quality improvement.
• Four out of six labor and delivery hospitals in Delaware have been designated as Baby Friendly, an international designation which recognizes facilities that provide the information confidence and skills to support infant feeding and mother-baby bonding: Beebe Healthcare, Bayhealth Kent General Hospital, Bayhealth Milford Memorial Hospital and Christiana Care Health System. Approximately 79% of births in Delaware now occur in facilities designated as Baby-Friendly.
• 712 health care practitioners from OB/GYN, family practice and pediatrics offices across the state have been trained in breastfeeding best practices.
• Two major annual events, the Delaware State Fair and the Firefly Music Festival, have incorporated breastfeeding-friendly areas to support families attending the festivities.

Four out of six labor and delivery hospitals in Delaware have been designated as Baby Friendly, an international designation which recognizes facilities that provide the information confidence and skills to support infant feeding and mother-baby bonding: Beebe Healthcare, Bayhealth Kent General Hospital, Bayhealth Milford Memorial Hospital and Christiana Care Health Systems. Approximately 79% of births in Delaware now occur in facilities designated as Baby-Friendly. Quality improvement efforts related to breastfeeding support at Saint Francis Hospital and Nanticoke General Hospital.

For more information on breastfeeding, visit the Breastfeeding Coalition of Delaware at www.delawarebreastfeeding.org/, or on Facebook at: https://www.facebook.com/DEbreastfeeding/, the DPH WIC page at http://dhss.delaware.gov/dhss/dph/chca/dphwicbfhom01.html or the CDC at http://www.cdc.gov/breastfeeding/.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

MEDIA ADVISORY
To promote breastfeeding, All Delaware hospitals discontinue formula gift bags to new mothers

WHO: Rita Landgraf, Secretary, Delaware Health and Social Services (DHSS)
Karyl T. Rattay, MD, MS, Director, Delaware Division of Public Health (DPH)
Penny Short, Chief Operating Officer/Chief Nursing Officer, Nanticoke Memorial Hospital
Nancy Hastings, IBCLC, Lactation Consultant, Beebe Healthcare
Kate Libby, a breastfeeding mother
Breastfeeding Coalition of Delaware

WHAT: Press conference announcing that all Delaware hospitals have discontinued the decades-old tradition of providing formula gift bags to new mothers. Delaware is the third state to “ban the bags.”

WHY: Breastfeeding is an infant’s best nutritional source. Breastfeeding protects babies from sudden infant death syndrome (SIDS), diarrhea, ear infections, pneumonia, allergies, and asthma. Babies who are breastfed for six months are less likely to become obese. Additionally, mothers who breastfeed have less risk of breast and ovarian cancers, and lose pregnancy weight faster.

WHEN: Thursday, July 23, 2015, 1:00 p.m. – 2:00 p.m.

WHERE: Nanticoke Memorial Hospital – Board Room
801 Middleford Rd.
Seaford, DE 19973

Directions:
http://www.nanticoke.org/locationsanddirections/

VISUAL: Mothers holding their breastfed infants.

QUESTIONS: 302-744-4704.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

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Rita Landgraf, Secretary
Emily Knearl, DPH Director of Communications
302-255-9047, Cell 302-354-2852
Email: emily.knearl@delaware.gov

Delaware Health and Social Services – Division of Public Health