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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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