Feeding Your Baby: A Novel Web-based Intervention for Breastfeeding Mothers and MCH Providers

Breastfeeding and providing human milk to infants provides significant advantages over formula feeding with regard to a baby's general health, growth, and development as well as significant benefits to mothers, families and society. For these reasons, exclusive breastfeeding is recognized as the optimal nutrition for infants in the first 6 months of life, with continued breastfeeding through the first 1 to 2 years. Healthy People 2010 goals are to have 75% babies initiate breastfeeding and 50% continue breastfeeding till at least 6 months. Despite the known benefits of breastfeeding, many mothers find it difficult to meet these goals with national averages of continued and exclusive breastfeeding at 6 months falling well below the national goals. For these mothers, finding ways to promote continued breastfeeding is essential. Varied primary care interventions have proven effective in increasing breastfeeding duration and exclusivity with activities related to direct support and education having the greatest impact. Though clinician support has been found to improve breastfeeding duration, providers have been inconsistent in their counseling and perceived by mothers as not having counseled them at well-child visits. Lack of sufficient time to provide effective counseling remains a significant barrier for clinicians. Ambulatory waiting times provide the perfect opportunity to supplement education at well-child visits and help compensate for this limited clinician time. Interactive web-based programs, such as Feeding Your Baby, grounded in adult education theory and strategically placed in ambulatory settings present an ideal vehicle for providing maternal education and assessing needs prior to visits.

Feeding Your Baby (www.feedingyourbaby.org) provides a series of online interactive modules designed to foster knowledge about infant nutrition with a goal of increasing breastfeeding rates in infants from birth through 6 months of age. Maternal responses to questions form a needs assessment which the health care practitioner can use to facilitate anticipatory guidance during the well child visit in a time efficient manner. A pilot test is underway utilizing a randomized control method with mother-baby pairs to determine improvements in breastfeeding outcomes on a state-wide level through regional outreach in New Hampshire. We believe that a web-based tutorial and needs assessment designed specifically for breastfeeding mothers can serve as an effective education tool and prompt for provider counseling at well-child visits and that this improved breastfeeding knowledge and focused provider counseling will result in increased breastfeeding duration and exclusivity. As maternal confidence with breastfeeding is a strong determining factor in duration, increasing maternal confidence through increased knowledge and support will result in increased breastfeeding duration and exclusivity as well. An increase in breastfeeding duration and exclusivity will have long standing health and economic benefits for babies, mothers, families and society both locally and on a national level. This intervention model of patient education, needs assessment and targeted counseling may be considered for a number of other child health care issues such as safety and injury prevention and chronic illness preventive care.