Breastfeeding supports and challenges: Report Highlights

Minnesota Breastfeeding Coalition meeting(St. Paul, MN)

October 25, 2010

Laura SchaubenWilder Research

Background

Purpose of study

To learn more about how to promote a supportive environment for breastfeeding

Primary foci was healthcare and employment settings

Collected some information about influence of childcare and family and friends as well.

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Methodology

Given limited resources, emphasized learning about women who are underrepresented in current literature

─ Rural women

─ Low-income women (level of education used as proxy)

─ Somali women

─ Native American women

─ Hmong and Latina focus groups also added

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Methodology

12 focus groups (95 participants)

─ Focus of questions was environmental conditions

─ Participants generally readily discussed personal experience

82 interviews

─ Focus of questions was personal experience

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Participants

Primarily 18-34 years old (focus group: 85%, interview participants: 86%)

College degree or higher (focus group: 20%, interview participants: 36%)

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Participants

Most common race/ethnicity:─ White (focus group: 33%, interview participants: 59%)─ Hispanic/Latina (focus group: 21%, interview participants

5%:)─ African American/African (focus group: 20%,

interview participants 18%)─ Native American (focus group: 18%, interview

participants 19%)

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Participants

Employment status─ Stay-at-home parent (focus group: 41%, interview participants: 43%)─ Employed PT or FT (focus group: 37%, interview participants: 35%:)

Geography: Twin Cities (focus group: 49%, interview participants: 68%)

Number of children─ Mean=2─ Mode=1─ Range: 1 - 11

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Findings

Infant feeding: Plan before birth

Before their babies were born:

─ 75% of women planned to breastfeed exclusively

─ 8% planned to breastfeed in combination with formula

─ Largest influence (besides their own previous experience) was family and friends

Almost all who planned to breastfeed, initiated it

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Infant feeding: Current method

≤6 mos. (N=77)

7-12 mos. (N=90)

Total(N=167)

Breastfeeding 39% 48% 44%

Formula feeding 47% 38% 42%

Both breastfeeding and formula

14% 10% 12%

Other (solids, milk) 0% 4% 2%

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Perceived benefits

Breastfeeding Formula feeding

Healthier for baby (more vitamins, better immunity) and mom (better weight loss and lower cancer risk)

Convenient (less embarrassing, more independence for Mom, More bonding time for Dad, keeps baby full longer)

Important bonding opportunity More comfortable for mom

Convenient Healthier for baby (more vitamins in formula)

Inexpensive/less expensive Easier to monitor how much baby is eating

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Health care: Sources of information

Literature most common

Verbal advice and hands on help also common

Many women received formula at hospital

A few women took classes and/or noted hospitals encouraging skin-to-skin contact

Most information provided at hospital (rather than during prenatal appointments)

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Health care: Influence on infant feeding

Overall, participants did not feel their health care provider influenced their decision, as generally their decision was already made

Participants did want and appreciate providers support for their infant feeding decision

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Health care: Participants’ recommendations

Provide more information on

─ Logistics of breastfeeding

─ Formula

─ Combining breastfeeding and formula feeding

Provide mothers with a mentor/“breast buddy”

Include infant feeding as part of birth plan

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Work site: Sources of support

Formal policies: existence and enforcement

Space: Privacy and availability

Time: Availability and impact on others

Storage: Privacy and proximity

Emotional support: Supervisors and co-workers

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Work site: Influence of infant feeding

For many stay-at-home moms, wanting to breastfeed influenced decision not to work.

Most participants who returned to work didn’t feel doing so influenced their feeding plans

However, small group of women said going back to work was catalyst for using formula

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Social support:

Women most influenced by family and friends beliefs and experiences.

Partners most common source of support

Mothers, other family members, and friends provide advice and support

WIC program also mentioned as source of information and resources

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Population-specific findings

Substantial more similarities than differences

Native American participants

─ Breastfeeding is seen at traditional for Native American mothers and having benefit for mother and baby

─ Small proportion than participants overall planned to breastfeed

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Population-specific findings

Latina participants

─ Believed breastfeeding natural and common in their culture

─ Some feared losing their job if they requested too many accommodations for pumping

Somali participants

─ Breastfeeding supported by Qur’an

─Most stayed at home in order to breastfeed

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Population-specific findings

Hmong participants

─ See breastfeeding as cheaper and good for bonding. Few mentioned health benefits

─ Described hearing others opinions about how they feed their baby as stressful

Women with a HS education or lower

─ See breastfeeding as more convenient and healthier

─ Formula led to faster weight gain for babies, allowed family members to help, and was less embarrassing

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Recommendations

Recommendations: Health care system

Use multiple methods and mediums to share information

Ensure information is culturally-appropriate

Talk about breastfeeding early

Include feeding as part of the birth plan

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Recommendations: Work site

Provide facilities for breast milk pumping and storage

Dedicate a staff member to support women

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Recommendations: Government

Develop a public awareness campaign

Increase awareness of the benefits of breastfeeding in cultural communities

Develop or expand peer support networks for breastfeeding

Educate worksites on existing state breastfeeding policies and how to implement them

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