Promoting Breastfeeding in Healthy Start

Background: The federally funded Healthy Start (HS) program mission is to reduce racial/ethnic disparities in perinatal health and infant mortality. Breastfeeding rates are particularly low among African American mothers. Activities and approaches used by HS projects to promote breastfeeding will be discussed in light of the social and economic conditions that create barriers to successful breastfeeding initiation and continuation.

Methods: As part of a national cross-site evaluation of the HS program, we reviewed project impact reports and surveyed 104 HS grantees in 2011 to assess project service and system implementation and to gather data on participant outcomes.

Results: All grantees addressed breastfeeding in project activities; common approaches included discussing breastfeeding during home visits, providing individualized breastfeeding counseling, and offering breastfeeding equipment to participants. In 2010, over three-quarters of grantees provided staff training on breastfeeding and over half of projects were involved with community-wide efforts related to breastfeeding. Nearly two-thirds of projects had a private space available for breastfeeding for staff and participants, and 44% had breast pumps available to loan or donate to participants. Findings on breastfeeding activities will be reported by grantee characteristics (i.e., stage of implementation, coordination and collaboration with other health and community-based organizations), characteristics of HS participants, and community contextual conditions.

Conclusions: Community-based HS projects provide services to populations with persistently low rates of breastfeeding; all projects currently address breastfeeding through program activities. Results will inform ongoing development and dissemination of approaches to integrating breastfeeding education and support into public health programs for new families.