A geographic comparison of disparities in breastfeeding patterns and the availability of lactation services: A community analysis of Maricopa County, Arizona

Lactation services are essential for many women in overcoming challenges that may arise while breastfeeding. According to the CDC Breastfeeding Report Card, 76.6 % of all women in Arizona initiate breastfeeding, which exceeds the 2010 objective (75%). On other outcome indicators, Arizona falls below recommended targets. On the CDC's mPINC scoring of process indicators of supportive breastfeeding environments, Arizona's score (62) falls just below the national mean (63). Maricopa County, the largest and most populous county within the state, has substantially lower breastfeeding rates in minority populations than state averages, particularly within African Americans and Native Americans. The study purpose was to (1) identify and characterize existing lactation services and (2) compare the service locations with breastfeeding rates geographically. Telephone surveying and GIS mapping were employed. CDC outcome and process indicators were used to create the telephone survey; hospitals, WIC offices, LaLeche League leaders, Lactation Consultants and Pediatrician offices were surveyed. Analysis revealed wide variation in definitions of breastfeeding support services, lack of knowledge about community resources, and inconsistencies in evidence-based practices. Using GIS mapping software existing breastfeeding rate data segmented by neighborhoods were layered on top of the lactation service information, then an additional layering of ethnicity and SES were done. Results are displayed in map format, allowing visual as well as precise determinations of underserved areas. It is essential that breastfeeding promotion and support program planning target the underserved; developing community-level understanding of service availability opens new avenues for efficacy in resource distribution and coordination of services.