Strategies to Implement a National Breastfeeding Awareness Campaign at the Local Level
Felicia Washington, MPH(1), Nathalie Bartle, EdD(2) and Lila Slovak(3)
(1) Drexel University- School of Public Health, Mail Stop 660 , 245 N. 15th Street, Philadelphia, PA 19102.
(2) Professor, Associate Dean for Student Affairs, Drexel University- School of Public Health, Mail Stop 660 , 245 N. 15th Street, Philadelphia, PA 19102.
(3) Program Associate, Maternity Care Coalition, 2000 Hamilton St., Suite 205, Philadelphia, PA, 19130.
Background: Despite the overwhelming research affirming the numerous benefits of breastfeeding, in the United States (U.S.) there has been a decline in the number of mothers who breastfeed from initiation to six months postpartum, especially in minority communities. Although the American Academy of Pediatrics (AAP) recommends breastfeeding exclusively for a period of 6 months, 37% of mothers who breastfeed at all stop before 6 months. In comparison to other developed countries, the U.S. breastfeeding duration rates are low and minimal progress has been made in the last decade.
Objectives: To determine strategies to implement the first National Breastfeeding Awareness Campaign at the local level; to describe factors that enable minority women, who are identified as non-traditional breastfeeding populations, to overcome breastfeeding barriers; and to identify breastfeeding resources within the community.
Design/Methods: This project included a review of the literature to analyze and evaluate national and international campaigns in an effort to understand effective strategies that may be employed to promote breastfeeding. In addition, qualitative data were collected from 15 mothers who chose to breastfeed despite cultural, social, and economic barriers. Open-ended interviews were conducted to identify central themes about their decision to breastfeed, barriers experienced, and their advice to mothers who are contemplating breastfeeding their infants. These central themes were analyzed using the Theory of Reasoned Action to determine strategies that lead to effective outcomes: high breastfeeding initiation and duration rates.
Results: The results of this project revealed that effective implementation of a breastfeeding campaign in low-income minority communities is based on a multi-layered approach that incorporates the community and theory to address local issues. This led to the development of a community-based and theoretical model called “O.U.T” which focuses on Outreach, Unification, and Transformation. Each strategy of the model is inherently centered on the community because community involvement at all levels leads to the most effective outcome of any campaign based on the literature. Key issues that emerged from the interviews were opposition to breastfeeding, high-level of self-determination, motivation, independence, and lack of resources, other themes included public humiliation and isolation.
Conclusion: Low-income mothers who breastfeed have exceptional levels of support and personal motivation that empowers them to overcome barriers and make healthy decisions for themselves and their children. However, results of this project suggest that although social support is important, factors such as high-level of self-determination, motivation, independence, and available resources contribute to higher success rates in comparison to mothers who just have support. These findings support the development and implementation of effective strategies in order to achieve successful initiation and duration rates among low-income women.