To improve equity in breastfeeding rates and eliminate breastfeeding disparities, the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity in 2014 funded the National Association of County and City Health Officials (NACCHO) through a cooperative agreement to implement the Reducing Disparities in Breast-feeding through Peer and Professional (Lactation) Support project (Breastfeeding Project). The purpose was to increase the implementation of evidence-based and innovative breastfeeding programs, practices, and services, specifically focusing on peer and professional lactation support for pregnant and postpartum women in predominantly African American and underserved communities with low breastfeeding rates.
Between January 2015 and June 2016, NACCHO provided $2.9 million in funding through reimbursement grants and more than 1,500 hours of training and technical assistance to 69 organizations to implement 72 breastfeeding demonstration projects in 32 states and U.S. territories. This Breastfeeding Project represents the most extensive U.S.-based implementation of coordinated community-level breastfeeding support projects.
This overview of the Breastfeeding Project highlights the work of 19 Breastfeeding Project grantees. The goal of sharing these stories is to increase awareness of the processes, successes, and challenges of implementing and expanding access to lactation support services for families and communities that have been historically marginalized and underserved. These examples can assist other communities to design sustainable breastfeeding support programs that increase availability and accessibility to skilled lactation care to improve equity in breastfeeding care.
Grantee Abstract submitted by Carmen Moore, RN, BSN, CLS (Parkview Health)
Integrating Breastfeeding Support Into Social Services Programs
Background: Rates of breastfeeding in the state of Indiana fall short of the Healthy People 2020 goals. There is also a disparity in breastfeeding rates among African Americans and Caucasians in the state. The Indiana Breastfeeding Task Force developed a plan of action that aligns with and supports the goals of the U.S. Breastfeeding Committee, the Indiana Perinatal Network, and the American Academy of Pediatrics. These goals are to (a) assure access to comprehensive, culturally appropriate lactation care for all families, (b) ensure that breastfeeding is recognized as the normal and preferred method of feeding young children, (c) ensure that federal, state, and local child welfare and family laws support the importance of breastfeeding, and (d) increase protection, promotion, and support for breastfeeding mothers in the workforce.
Methods: Parkview and its community partner, Stop Child Abuse and Neglect (SCAN) Healthy Families department, provided evidence-based prenatal breastfeeding education and support to pregnant and postpartum mothers, with the goal that more African American mothers initiate and continue breastfeeding in Allen County, Indiana. The targeted area was southeast Fort Wayne, a designated Medically Underserved Area, which includes a large African American population. Professional and peer breastfeeding support were provided through support groups, individual counseling, and home visits. With funds from the National Association of County and City Health Officials (NACCHO), two African American social workers were trained as Certified Lactation Specialists (CLSs). The CLSs were recruited from the SCAN existing staff and were familiar with the community and connected to the families. Experience has shown that new mothers and families are more likely to listen to and heed advice from someone who is perceived as part of the community.
Results: As a result of this project, Parkview Health increased the provision of breastfeeding services from one support group per week to nine groups per month within the targeted area. In addition, home visits were provided to mothers who were unable to attend the group session because of medical conditions. Furthermore, Parkview developed several culturally sensitive breastfeeding education and marketing materials. The materials feature photos of families and infants of color, with information on breastfeeding benefits for mother and infant and also contact information for local support and resources, including the CLSs. Over a 12-month period, from March 2015 to February 2016, a total of 97 breastfeeding support groups were hosted, which included a total of 626 face-to-face encounters with mothers engaged in the breastfeeding program. The women who received support were primarily White and African American. Overall demographics were 232 White, 194 African American, 100 Hispanic, 45 Asian, 8 American Indian, and 47 of other races.
Conclusion: The NACCHO funding increased Parkview Health and SCAN’s organizational capacity to provide breastfeeding support. Lactation support has been incorporated into job responsibilities for the program to be sustained. The increase in attendance at the breastfeeding support groups and the additional home visiting requests have led this initiative to develop a new registered nurse position, who will be trained in lactation management. Last, the nine support groups per month have been maintained, with approximately 8 to 10 women in attendance per session. As this program continues, the goal is to close the breastfeeding gap in Allen County.
Journal of human lactation : official journal of International Lactation Consultant Association
Keitt, Sheree Holmes; Reis-Reilly, Harumi; Fuller-Sankofa, Nikia; Carr, Margaret; and Moore, Carmen, "Breastfeeding in the Community: Sharing Stories on Implementations That Work." (2018). Articles. 19.