ABSTRACT. Objective. Beginning in 1990, Georgia's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) initiated 5 new strategies to promote breastfeeding among its pregnant and postpartum clients. These strategies were implemented in 1991, each to be provided as an addition to its standard program of counseling on breastfeeding and distributing appropriate literature: 1) enhanced breastfeeding education, 2) breast pump loans, 3) hospital-based programs, 4) peer counseling, and 5) community coalitions. The enhanced breastfeeding education strategy provides access to a hotline as well as periodic training of staff, and the breast pump loan provides free breast pumps to mothers who want to use them. The hospital-based strategy provides bedside support and counseling to women who have just given birth and includes staff training, as well as a hotline number for women to call after they leave the hospital. The peer-counseling strategy focuses on identifying former WIC participants who have successfully breastfed their infants; these women are recruited to provide support and encouragement to current WIC participants. Finally, the community coalitions approach is designed to identify existing community attitudes about breastfeeding, establish plans to address gaps in breastfeeding services, to develop resource guides on breastfeeding for the community, and to advocate at the community level to support breastfeeding women. The objective of our research was to evaluate the impact of breastfeeding promotion strategies on breastfeeding initiation among WIC participants in Georgia.Methods. Using data from the Pregnancy Nutrition Surveillance System (PNSS) for 1992-1996, we examined breastfeeding initiation rate during this period and compared rates among 6 different intervention strategies. Also, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to assess breastfeeding initiation and duration among WIC enrollees. We conducted 13 focus groups to understand the experiences of program participants. Ten focus groups were conducted with women who were breastfeeding their infants, 3 each with women from the community coalitions, hospitalbased programs, and standard education programs, and 1 with women from the breast pump loan program. Three focus groups were conducted with women who were feeding their infants formula.Results According to PNSS data, the largest increases in breastfeeding initiation for 1992 to 1996 were among younger women (<19 and 20 -24 years old), those with no college (less than high school and high school only), unmarried, and black women (see Table 1). The smallest increases during this period were among older women (30؉), those with more than a high school education, and women who were white, Hispanic, or from other ethnic or racial groups. The PRAMS data (1993-1996) generally display similar results, but the pattern by marital status demonstrated larger increases for married women than for unmarried women.Most programs demonstrated an increase in the brea...
Because social and cultural norms are associated with women's breastfeeding behaviors, it is important to understand public opinions toward breastfeeding in the United States. Using data from the Healthstyles survey, the authors examined regional variations in (1) public knowledge about health benefits of breastfeeding, (2) public attitudes toward breastfeeding in public, (3) public support for workplace breastfeeding policies, and (4) public perceptions about breastfeeding duration. Pacific, West South Central, West North Central, and Mountain respondents were the most knowledgeable about the health benefits of breastfeeding. Mountain, New England, and Pacific respondents exhibited the most positive attitudes about breastfeeding in public. Mountain and Pacific respondents showed the strongest support for workplace breastfeeding policies. Pacific, Mountain, and East North Central respondents displayed the most positive perceptions about breastfeeding duration. This study emphasizes the need to learn from the best regions and apply subsequent findings to those regions having less positive public opinions and low breastfeeding rates.
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