The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #72795

Deborah L. Dee, MPH, Dept. of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, CB# 7445, Rosenau Hall, Chapel Hill, NC 27599-7445, 919.966.6648, deborah_dee@unc.edu

Breastfeeding is the ideal form of nutrition for infants, offering numerous maternal and child health benefits, yet U.S. Healthy People 2010 breastfeeding goals are not being met. Lack of postpartum support may be an explanatory factor. The In-Home Breastfeeding Support Program of North Carolina (IHBSP) provides breastfeeding education and support in establishing lactation and prolonging breastfeeding, primarily for low-income women. Mothers who wish to breastfeed are paired with program assistants (PAs) for up to one year of breastfeeding support through hospital and home visits, and by phone contacts at predetermined times. This study examined the impact of the IHBSP on breastfeeding duration, and sought to identify salient elements of the program. Duration data were available for 4,447 clients who stopped breastfeeding during fiscal year 2002. Eighty-nine percent of clients were still breastfeeding at 2 weeks postpartum; 73% at 6 weeks; 58% at 3 months; 42% at 6 months; and 18% at one year. Qualitative data were collected through focus groups and in-depth interviews of program administrators, PAs, and clients, and were analyzed using N*Vivo. The ability to extend duration was attributable to the immediate, hands-on assistance in the home from a trusted, knowledgeable person (the PA) at crucial times, such as when milk comes in or upon returning to work or school. The ability of PAs to deliver effective support was facilitated in part by intensive, extensive training. Challenges to helping clients continue to breastfeed included large caseloads, physicians' ambivalence toward breastfeeding, and clients' embarrassment about breastfeeding in public.

Learning Objectives:

• 1. Describe the impact of the In-Home Breastfeeding Support Program on breastfeeding duration among low-income women in North Carolina.
• 2. Identify important features, as well as challenges, of a successful postpartum breastfeeding support program.
• 3. Replicate the In-Home Breastfeeding Support Program’s model in the participant’s community to help improve breastfeeding initiation and duration in the U.S.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.