246828 Operation Initiation: A look through the window of opportunity that facilitates successful breastfeeding initiation

Tuesday, November 1, 2011: 2:30 PM

Sherry Mukasa Matemachani, CHES , School of Nursing, Indiana University Purdue University Indianapolis, Indianapolis, IN
Joanne Martin, DrPH, FAAN , School of Nursing, Indiana University Purdue University Indianapolis, Indianapolis, IN
Background: Evaluation was conducted on the integration of a peer-based community intervention model within an existing home-visitation program (HVP) that served Medicaid-eligible women at risk for child maltreatment. The intervention was designed to improve prenatal and childbirth outcomes, although the impact on breastfeeding warranted a closer look at the program components that contributed to impressive initiation rates.

Methods: A non-profit organization received philanthropic funding to partner with the HVP and conduct a two-year pilot of the integrated intervention. A total of 102 women under age 24 were enrolled; 73% were African-American. Four community workers were employed and specially trained as doulas to provide support during the critical months of pregnancy, birth and early parenting.

Results: Pregnancy outcomes among the 78 active participants who had given birth were equal to or better than a non-equivalent comparison group of mothers similar in ethnicity, age, and residency. Breastfeeding initiation was most promising: 92% initiated breastfeeding, compared to 55% in the comparison group. The lessons learned could enhance efforts to increase breastfeeding. Namely, train trusted community members to: 1) provide breastfeeding education as part of prenatal and childbirth support; 2) facilitate successful initiation by offering encouragement and breastfeeding support at the time of birth, through the critical hours that follow; 3) continue home-based support during the critical weeks that breastfeeding is established.

Conclusion: Community-based programs are ideally positioned to train community members who are willing to provide breastfeeding support during critical periods. Their ability to effectively support breastfeeding contributes to developing healthier communities.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
1. Explain the key components to consider when integrating a community-based prenatal education and childbirth support model within an existing home visitation program 2. Identify important elements of breastfeeding education and support, which can be used to encourage initiation among low-income pregnant women 3. Evaluate feasibility of implementing a similar approach to meet the needs of pregnant and breastfeeding women in an identified community

Keywords: Breast Feeding, Prenatal Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a program evaluator and have participated in the design, development, and implementation of the overall evaluation plan. I have also provided coordination support from the program's inception through the initiating organization.
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.