Alleghany County Self Appraisal

Step 1: Leadership Support for Breastfeeding (In Progress)

Celebration:
AppHealthCare and WIC leaders, including Lori Cimino, have expressed commitment to achieving “district-wide breastfeeding-friendly” status. Alleghany’s strong WIC participation and consistent leadership buy-in position the county well for formal designation.

What They’re Already Doing:

  • Building shared commitment among AppHealthCare and WIC leadership.
  • Leveraging Alleghany County’s strong WIC participation as a foundation for district progress.
  • Maintaining consistent leadership engagement and support for breastfeeding initiatives

Measures:

  1. Your community has a signed proclamation and/or policies that include action steps to support all the steps to becoming a Breastfeeding Family Friendly Community. Proclaim every 3 years. (1i)
  2. Your community routinely shares the signed proclamation/policies via social media and other local media outlets. 
  3. Your community ensures that local media outlets host an annual discussion with chest/breastfeeding experts on this issue.
  4. Your community distributes a copy of the Ten Steps designation and the local policy/proclamation at least annually, ideally during World Breastfeeding Week or National Breastfeeding Month.

Step 2: Welcoming Atmosphere for Breastfeeding Families (In Progress)

Celebration:
Breastfeeding-friendly signage is displayed at AppHealthCare. Team acknowledged (and plans to leverage) first-responder engagement model used successfully in other NC communities (Asheville/Henderson/Yancey) as the template for Alleghany — reflecting shared understanding of what “welcoming” looks like on the ground.

What They’re Already Doing:

  • Displaying breastfeeding-friendly signage at AppHealthCare locations.
  • Reviewing and adapting the successful first-responder engagement model from Asheville, Henderson, and Yancey Counties.
  • Building a shared understanding of what a truly “welcoming” community looks like in practice.
  • Alleghany Library already participates as a breastfeeding-friendly business and displays a cling from the NC Breastfeeding Coalition.
  • Both local coffee shops and the library currently have signage posted.
  • Approximately 7–8 employers and community partners have breastfeeding-friendly signs displayed.
  • Several Main Street businesses and the Chamber of Commerce also display window stickers.

Measures:

  1. unchecked Your community has posted chest/breastfeeding “Welcome” signage next to the community’s welcome signs or in other prominent locations. (e.g., City operated parks, swimming pools, senior centers, etc.) (2i)
  2. unchecked Your community displays a chest/breastfeeding “Welcome” seal/logo on community websites and/or social media, or makes flyers available at visitor centers.
  3. unchecked Your community enforces federal or state laws that support public chest/breastfeeding.(e.g., North Carolina law states that mothers have the right to breastfeed anywhere they are legally allowed to be)

Step 3: Support from Health Leadership (In Progress)

Celebration:
Leadership from AppHealthCare, WIC, and Alleghany Memorial Hospital have confirmed interest in integrating WHO breastfeeding definitions and policy. Team acknowledged (and plans to leverage) first-responder engagement model used successfully in other NC communities (Asheville/Henderson/Yancey) as the template for Alleghany — reflecting shared understanding of what “welcoming” looks like on the ground.

What They’re Already Doing:

  • Engaging leadership across AppHealthCare, WIC, and Alleghany Memorial Hospital to integrate WHO breastfeeding standards.
  • Reviewing policies to ensure consistency with international best practices.
  • Drawing from successful first-responder engagement models in Asheville, Henderson, and Yancey Counties to guide implementation.

Measures:

  1. unchecked The Designating Team or your local Breastfeeding Coalition identifies the health leaders in your community, such as the local health department director, WIC office director, hospital board members, or head nurse at the local hospital. (3i) 
  2. unchecked The defined health leaders have confirmed and approved the World Health Organization’s definition of optimal infant feeding, or an equivalent, and this definition has been disseminated to healthcare providers and community leaders.

Step 4: Information During Pregnancy (In Progress)

Celebration:
WIC and healthcare providers distribute consistent educational materials about breastfeeding benefits and support resources. WIC and health-department educators at the table (Karina, Tiffney, etc.) committed to bring in faith/community partners via existing coalition spaces — a channel they already use for prenatal information distribution.

What They’re Already Doing:

  • Sharing aligned breastfeeding education materials across WIC and healthcare settings.
  • Ensuring consistent messaging about breastfeeding benefits and local supports.
  • Engaging faith and community partners through existing coalition spaces.
  • Leveraging established prenatal information channels to expand outreach.

Measures:

  1. unchecked Healthcare systems in your community distribute non-commercial materials about the benefits of chest/breastfeeding and the risks of unnecessary formula use to faith-based and community organizations (4i)
  2. unchecked Community-based organizations distribute non-commercial materials about the benefits of chest/breastfeeding and the risks of unnecessary formula use.
  3. unchecked Distributed materials are culturally appropriate and reflective of the population served.
  4. unchecked Distributed materials include information on where to access chest/breastfeeding support as needed.

Step 5: Breastfeeding-Friendly Healthcare (Planning)

Celebration:
Alleghany Memorial Hospital provides breastfeeding education and referrals to WIC and community programs. Provider alignment groundwork is in place via AppHealthCare leadership; Tiffney is already working with clinics/schools/churches — the existing relationships underpin future clinical alignment/training.

What They’re Already Doing:

  • Delivering breastfeeding education and referral services through Alleghany Memorial Hospital.
  • Strengthening alignment between healthcare providers, WIC, and community programs.
  • Building on AppHealthCare’s leadership to establish consistent clinical practices.
  • Leveraging Tiffney’s existing relationships with clinics, schools, and churches to sustain outreach and trust.

Measures:

  1. unchecked All maternity care centers in your community are designated Baby-Friendly or hold an equivalent state-level designation that supports chest/breastfeeding. (5i)
  2. unchecked At least 50% of prenatal and postnatal outpatient care clinics in your community have applied for or documented breastfeeding-friendly support and training.

Step 6 Availability of Lactation Support (Pass)

Celebration:
Active WIC lactation counselors and peer counselors are available. Regional IBCLC coverage exists via AppHealthCare partnerships. WIC exclusive-breastfeeding performance is over 40%, and the peer counselor program was expanded — a concrete services success they’re proud of and leveraging. Lori underscored decades of district lactation leadership and momentum (“numbers skyrocketed on exclusiveness”), confirming strong service capacity. 

What They’re Already Doing:

  • Maintaining active WIC lactation and peer counselor programs.
  • Leveraging regional IBCLC coverage through AppHealthCare partnerships.
  • Supporting strong exclusive-breastfeeding performance (over 40%).
  • Expanding the WIC peer counselor program to reach more families.

Measures:

  1. checkedYour community has established or confirmed the availability of active chest/breastfeeding support groups.(6i)
  2. checked Your community has established or confirmed the availability of Lactation Consultants: International Board Certified Lactation Consultants (IBCLCs) and other skilled lactation support services.
  3. checked Make a comprehensive resource list of the lactation support (support groups, IBCLCs, classes, etc) in your community. 
  4. checked Special attention is given to ensuring that lactation support services meet the needs of marginalized and underserved communities.
  5. checked At least one in-person or virtual meeting has been held annually to coordinate chest/breastfeeding support efforts in your community.
  6. checked Your community has communicated information about available lactation support services to the public at least once annually.

Step 7: Welcoming Businesses and Organizations (In Progress)

Celebration:
Alleghany County businesses are showing strong enthusiasm for the “Breastfeeding Welcome Here” campaign. Tiffney has been working hard to engage businesses and churches, and this early outreach energy is helping build momentum across the district.

What They’re Already Doing:

  • Conducting active outreach to local businesses and churches.
  • Starting implementation in Alleghany County as a model for other areas in the district.
  • Coordinating efforts with district leadership to ensure alignment with broader initiatives.

Measures:

  1. checked Your community has calculated the number of businesses needed to meet the Breastfeeding Family Friendly Community requirement: 24 (11,672/500= 23.34) (Total population / 500).(7i)
  2. unchecked At least one business for every 500 people in your community has signed a form stating they welcome chest/breastfeeding in their place of business.
  3. unchecked These businesses display welcome signs or a “Breastfeeding Welcome” logo.

Step 8: Adherence to the Code of Marketing (Planning)

Celebration:
AppHealthCare and WIC follow the Code; no formula promotion occurs within local healthcare facilities. Healthcare leadership commitment (AppHealthCare + WIC) and peer counselor infrastructure indicate they’re operating from non-commercial, counseling-first norms; this came up while discussing awards tied to exclusive BF and peer expansion. 

What They’re Already Doing:

  • Upholding the WHO Code by maintaining non-commercial breastfeeding environments.
  • Ensuring no formula marketing or promotion within healthcare or WIC settings.
  • Operating from a counseling-first model supported by strong healthcare leadership.
  • Integrating peer counselor infrastructure to sustain ethical, family-centered support.
  • Recognizing alignment with exclusive-breastfeeding awards and peer program growth.

Measures:

  1. unchecked Healthcare facilities in your community provide chest/breastfeeding education and support to parents without promoting commercial infant formula through ads or free samples.(8i)
  2. unchecked Locally-controlled grocery stores in your community do not promote commercial infant or related toddler formula through preferential shelf placement or ads.
  3. unchecked Locally-controlled food markets and convenience stores in your community do not promote commercial infant or related toddler formula through preferential shelf placement or ads.
  4. unchecked Locally-controlled pharmacies in your community do not promote commercial infant or related toddler formula through preferential shelf placement or ads.
  5.  Non-locally controlled grocery stores, food markets, convenience stores, and pharmacies in your community are encouraged to display lactation support information near infant formula/foods and to prevent local advertising of formula.

Step 9: Workplace Accommodation for Lactating Employees

Celebration:
AppHealthCare models compliance with the PUMP Act. Strategy to fold BFFC into existing workforce programs across the district (Lindsay) — that’s a real avenue already running, not a new build, for employer education and compliance.

What They’re Already Doing:

  • Ensuring AppHealthCare facilities comply with the PUMP Act requirements.
  • Integrating breastfeeding support into existing workforce and employer programs.
  • Leveraging Lindsay’s district strategy to align BFFC implementation with ongoing family-friendly and stable workplace initiatives.
  • Using current employer education channels rather than creating new structures.

Measures:

  1. unchecked The current state of the laws concerning mandated business support for chest/breastfeeding is made available to all Chamber of Commerce members, similar business groups, and other businesses (e.g., U.S. Dept. of labor materials provided by local chest/breastfeeding organization or health department) annually.(9i)
  2. unchecked The Chamber of Commerce, or a similar organization, disseminates the US Business Case for Breastfeeding, WABA maternity care, or equivalent materials annually.

Step 10: Education Systems Include Breastfeeding in Curriculum (Planning)

Celebration:
Alleghany County Schools and Head Start programs have shown interest in family health curriculum updates. Schools named as active relationship holders (“businesses, schools, churches”) via Tiffney — i.e., channels are already open for classroom/library integration starting in Alleghany.

What They’re Already Doing:

  • Identifying opportunities for classroom and library integration in Alleghany.
  • Building early partnerships between education and public health sectors

Measures:

  1. unchecked The local School District or Department of Education provides books and/or images that illustrate chest/breastfeeding as the norm.(10i)
  2. unchecked Chest/breastfeeding-friendly curricula are introduced at all levels of education.
  3. unchecked Your community’s preschools and early education centers include chest/breastfeeding-friendly curricula in their programs.
  4. unchecked Your public school system has introduced chest/breastfeeding-friendly curricula at all educational levels.
  5.  Universities in your community include chest/breastfeeding-friendly curricula in relevant courses or programs.