196825 Assessing local maternal and infant health providers in New York City: An essential first step for strategic planning of interventions aiming to make breastfeeding the norm

Wednesday, November 11, 2009

Erum K. Hadi, MPH , Bronx District Public Health Office, NYC Department of Health and Mental Hygiene, Bronx, NY
Jane F. Bedell, MD , Bronx District Public Health Office, NYC Department of Health and Mental Hygiene, Bronx, NY
Philip M. Alberti, PhD , District Public Health Office, NYC Department of Health and Mental Hygiene, New York, NY
Matilde Depena, BSc , CUNY Lehman College, Bronx, NY
Ruqayyah Abdullah, BSc , Bronx District Public Health Office, NYC Department of Health and Mental Hygiene, Bronx, NY
  
Breast milk strengthens infant's immune system; reducing risk for numerous childhood diseases . Breastfeeding decreases maternal risk of cancers, post-partum bleeding and Type II diabetes .

In New York City (NYC), 84% of mothers initiate breastfeeding at birth, exceeding Healthy People 2010 goal by 11%. By 8 weeks this rate drops by 23% . The NYC Department of Health and Mental Hygiene aims to increase rates of breastfeeding duration/exclusivity while promoting breastfeeding as the norm.

Research shows pre/post natal breastfeeding education/support, peer counseling, and provider education can help mothers maintain breastfeeding . We hypothesized a dearth of such education/support services in NYC's poorest communities and conducted a needs assessment to investigate this among maternal and infant health providers.

A 20 minute telephone survey of 211 providers in the South Bronx, East/Central Harlem and North/Central Brooklyn assessed barriers to breastfeeding support, client education services, and provider client discussion of health benefits, pain, intimacy and legal rights.

Very few providers offered support services such as multiple or group educational sessions, home visits, lactation consulting, active follow-up, electric pumps or educational materials to clients.

Among surveyed providers, pediatricians were least likely to provide breastfeeding support services. Only 12% of pediatricians provided breastfeeding group sessions as compared with 66% of obstetricians (OBGYNs) and 67% of WIC/social service agencies.

WIC/social service agencies were more likely to communicate breastfeeding guidelines and other issues compared with pediatricians and OBGYNs.

The breastfeeding assessment reveals a need for provider education, access to lactation consultants, pump provision and educational materials.

Learning Objectives:
1. Identify maternal and infant health providers in a community. 2. Assess maternal and infant health provider practices around promotion and delivery of breastfeeding services. 3. Develop list of breastfeeding friendly maternal and infant health practices for referrals of new moms. 4. Describe challenges faced by maternal and infant health providers in promotion and delivery of breastfeeding services.

Keywords: Breast Feeding, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a fellow researcher on the breastfeeding research project with the Bronx District Public Health Office of the New York City Department of Health. I have been involved in the data collection and reporting for this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Breastfeeding Potpourri
See more of: Maternal and Child Health