Georgia's Breastfeeding Promotion Program for Low-Income Women

Abstract

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...

Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC Programme

“…Studies of WIC groups suggest that participants are aware of the health benefits of breast-feeding for their infants, and that structural barriers such as return to work are less of a problem than attitudinal barriers, including embarrassment about public feeding, the perception of breast-feeding as limiting or inconvenient, and fears of inadequate supply (38) . Such attitudes are amenable to intervention and education, and WIC Programmes designed to educate participants and provide peer-counselling support services have shown that they can positively impact breast-feeding in this population (39)(40)(41) .…”

Racial and Ethnic Disparities in Breastfeeding

“…This makes direct comparisons of breastfeeding rates between studies problematic; this is especially true for the one study based on data from the 1990s. 56 The breastfeeding initiation rates for African American and AI/AN mothers remain significantly below the Healthy People 2020 goal, as does breastfeeding at 6 months for all groups.…”

“…Two studies 56,57 were identified evaluating the effectiveness of enhanced breastfeeding programs. Supporting the findings of Chapman and Pérez-Escamilla, 22 results from one study 56 demonstrated that enhanced hospital practices and WIC-based services can have a significant impact on breastfeeding initiation rates.…”

Effect of breastfeeding on weight retention from one pregnancy to the next: Results from the North Carolina WIC program

“…These benefits include protection for the infant from acute infections and chronic digestive diseases, and for the mother protection from ovarian and breast cancer (American Academy of Pediatrics, 1997; US Department of Health and Human Services, 2000). WIC programs that educate participants and provide peer-counseling support services can positively impact breastfeeding in this population (Ahluwalia et al, 2000;Finch and Daniel, 2002;Gross et al, 2009) and the new WIC food package design, effective October 1, 2009, is also an important breastfeeding promotion effort (Holmes et al, 2009;Institute of Medicine, 2005b). Given that up to half of all infants in the US participate in WIC (Ryan and Zhou, 2006), encouraging breastfeeding in this population could benefit the overall health of a substantial proportion of American women and children.…”