This page documents Alleghany County’s progress toward becoming a Breastfeeding Family Friendly Community using the nationally recognized Ten Steps to a Breastfeeding Family Friendly Community framework.
The self-appraisal is both a public-facing overview and a working checklist for partners involved in implementation. It reflects ongoing collaboration between AppHealthCare (including its WIC program), healthcare providers, schools, businesses, and community organizations. Some sections include specific measures and detailed language because this page is used to track progress over time, guide planning conversations, and support formal designation.
Not all steps are expected to be complete at once. Several are marked In Progress or Planning to reflect where systems are already aligned and where additional work is underway. This process typically takes multiple years and is intentionally collaborative.
Alleghany County is exploring this work as part of a district-wide approach, aligning with existing initiatives such as Family Forward Certification and Stable Communities, so that breastfeeding support is embedded into systems that already serve families—rather than created as a stand-alone effort.
Step 1: Leadership Support for Breastfeeding (In Progress)
Celebration:
AppHealthCare (including its WIC program) has 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 (including its WIC program) leadership.
- Leveraging Alleghany County’s strong WIC participation as a foundation for district progress.
- Maintaining consistent leadership engagement and support for breastfeeding initiatives
Measures:
- 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)
- Your community routinely shares the signed proclamation/policies via social media and other local media outlets.
- Your community ensures that local media outlets host an annual discussion with lactation experts on this issue.
- 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:
- Your community has posted culturally inclusive breastfeeding “Welcome” signage next to the community’s welcome signs or in other prominent locations.
- Your community displays a inclusive breastfeeding “Welcome” seal/logo on community websites and/or social media, or makes flyers available at visitor centers.
- Your community enforces federal or state laws that support public 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 (including its WIC program) 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:
- 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)
- 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:
AppHealthCare including its WIC program and healthcare providers distribute consistent educational materials about breastfeeding benefits and support resources. WIC and health-department educators at the table 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:
- In Alleghany County, AppHealthCare administers the WIC program, which strengthens alignment between WIC services and district public health initiatives.
- 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:
- Healthcare systems in your community distribute non-commercial materials about the benefits of breastfeeding/lactation and the risks of unnecessary formula use to faith-based and community organizations (4i)
- Community-based organizations distribute non-commercial materials about the benefits of breastfeeding and the risks of unnecessary formula use.
- Distributed materials are culturally appropriate and reflective of the population served.
- Distributed materials include information on where to access breastfeeding/lactation 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. AppHealthCare’s Child & Family Wellness team is already working with clinics, schools, and faith/community partners — 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 existing relationships with clinics, schools, and churches to sustain outreach and trust.
Measures:
- All maternity care centers in your community are designated Baby-Friendly or hold an equivalent state-level designation that supports breastfeeding. (5i)
- 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. Team members underscore 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:
- Your community has established or confirmed the availability of active breastfeeding support groups.(6i)
- Your community has established or confirmed the availability of Lactation Consultants: International Board Certified Lactation Consultants (IBCLCs) and other skilled lactation support services.
- Make a comprehensive resource list of the lactation support (support groups, IBCLCs, classes, etc) in your community.
- Special attention is given to ensuring that lactation support services meet the needs of marginalized and underserved communities.
- At least one in-person or virtual meeting has been held annually to coordinate breastfeeding and lactation support efforts in your community.
- 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. Team members have 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:
- 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)
- At least one business for every 500 people in your community has signed a form stating they welcome breastfeeding in their place of business.
- 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:
- Healthcare facilities in your community provide breastfeeding/lactation education and support to parents without promoting commercial infant formula through ads or free samples.(8i)
- Locally-controlled grocery stores in your community do not promote commercial infant or related toddler formula through preferential shelf placement or ads.
- 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.
- Locally-controlled pharmacies in your community do not promote commercial infant or related toddler formula through preferential shelf placement or ads.
- 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. Through existing district workforce and Stable Communities programming— 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 existing district workforce and Stable Communities strategies to align BFFC implementation with ongoing family-friendly and stable workplace initiatives.
- Using current employer education channels rather than creating new structures.
Measures:
- The current state of the laws concerning mandated business support for 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 lactation organization or health department) annually.(9i)
- 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”) 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:
- The local School District or Department of Education provides books and/or images that illustrate breastfeeding as the norm.(10i)
- Breastfeeding-friendly curricula are introduced at all levels of education.
- Your community’s preschools and early education centers include breastfeeding-friendly curricula in their programs.
- Your public school system has introduced breastfeeding-friendly curricula at all educational levels.
- Universities in your community include breastfeeding-friendly curricula in relevant courses or programs.