Accentuating the positive: Community solutions to breastfeeding in New Orleans

In Louisiana only 56.6% of infants are ever breastfed, well below the national average of 75%¹. Less than a third of African-American women in LA initiate breastfeeding². Rates of infants still being breastfed at 6 months are even lower¹. Risk factors for not breastfeeding include being a recipient of WIC or having low education or SES levels². Researchers often focus on the barriers to breastfeeding but what can be learned from mothers who are overcoming them? Why are their behaviors different? Positive deviants are those who, despite being at risk, engage in beneficial practices and experience better outcomes than their neighbors with similar risks³. The positive deviance approach offers an alternative to needs-based approaches by looking at local solutions to overcoming barriers. The Mary Amelia Women's Health Education Center initiated a project to explore the use of surveys to identify positive deviants (PDs) for breastfeeding among a population at high risk for not initiating or continuing breastfeeding. We created and tested a survey tool to identify women who reported breastfeeding. Women at two pre-postnatal sites serving the uninsured, urban population in New Orleans were surveyed using our tool. We have successfully identified women who breastfeed despite risk factors. These women will participate in our Positive Deviance Inquiry (PDI) to identify coping mechanisms and behaviors that enable them to breastfeed. Findings from the project will be used to develop culturally appropriate breastfeeding programs.