Soul Food For Your Baby A breastfeeding project targeting African Americans Elizabeth Gant, MA, MPH Maternal, Child & Adolescent Health Los Angeles County.

Soul Food For Your

BabyA breastfeeding project

targeting African Americans

Elizabeth Gant, MA, MPHMaternal, Child & Adolescent Health

Los Angeles County

[email protected]

17th Annual CityMatCH Urban MCH Leadership Conference

Denver, CO • August 26-28, 2007

Today’s Outline

Background• L.A. County

Cultural Barriers Soul Food For Your Baby Current Status

The physical, psychosocial and emotional benefits of breastfeeding forinfants and mothers are well-documented.

For Baby:

Decreased illness during infancy (i.e., diarrhea, ear infections, colds/flus, etc.)

Probable reduction in certain chronic diseases later in life (i.e., diabetes, obesity, lymphoma, digestive diseases,& allergic diseases)

Probable reduction in SIDS

Enhanced cognitive development

Source: American Academy of Pediatrics, 2005

For Mom:

Increased bonding, lower risk of certain cancers, decreased risk of diabetes, weight loss, bone remineralization

For Society:

Lower medical costs for sick infants, reduced parent absenteeism from work

Source: American Academy of Pediatrics, 2005

The benefits are evident, but they are not equally shared

across racial groups.

One nationwide study found that African American

mothers were 2.5 times less likely to breastfeed compared

to Whites.

Source: Forste et al, 2001

The disparity persists in L.A. County

Breastfeeding rates 2002-2003

0

10

20

30

40

50

60

70

80

90

100

Initiation 6 mo 12 mo

Whites

Asian Americans

Latinas

African Americans

Healthy People 2010

Source: Los Angeles County Health Survey, 2002-2003

Background• L.A. County

Cultural Barriers Soul Food For Your Baby Current Status

Today’s Outline

Why?

Cultural knowledge

Attitudes

Behaviors

Common barriers Lack of education,

misinformation Embarrassment Need to return to work

or school Lack of social support Fear of pain, engorgement

& cracked nipples Perceived inconvenience

A tradition lost

Association with slavery

Commercialization of formula

Formula perceived as “normal” milk

Social stigma

Limitations of current interventions

Embedded in baby care curricula Culturally indistinct Time lag Do not target social norms Directed to limited populations

Background• L.A. County

Cultural Barriers Soul Food For Your Baby Current Status

Today’s Outline

Soul Food For Your Baby

SFFYB aims to target the social beliefs and

norms that hinder breastfeeding among African Americans.

Target populations

African American women living in South Los Angeles

• Ages 14-25 (about 2,000 women)

Secondary Targets – Social support network, i.e., partners, mothers, peers, female relatives

Source: 2005 Newborn Screening Data

Service Planning Area 6 Highest concentration of African

Americans – 34%

• Includes communities of Watts, Compton, Crenshaw

• 4,700 total Black births in SPA 6;

11,600 countywide

Most economically depressed area of L.A. County

• 28% of residents living 100% below the Federal Poverty Level in 2004

Highest teen pregnancy rate – 73.5/1,000 live births

Source: Los Angeles County Key Indicators of Health, 2002-2003; 2004 Title IV Perinatal Indicators

Modified Theory of Reasoned Action

(DiGirolamo et al, 2005)

Intention is the best predictor of behavior (initiation)

•Target individual, interpersonal, and social norms and attitudes

Experience is the best predictor of behavior maintenance

Methods

Two-pronged approach:

Social marketing – to target cultural knowledge, norms and attitudes

Direct services – to increase knowledge and enhance breastfeeding experience

SFFYB goals

Increase breastfeeding knowledge

Breakdown cultural taboos

Increase knowledge of ways to integrate breastfeeding into work/school schedules

Increase initiation and duration rates

Increase positive attitudes toward breastfeeding

Social Marketing

Billboard displays, bus shelter ads

Posters Leaflet distribution

• Brochure, info cards, booklets

Web site Radio/TV PSAs & interviews

Samples

Direct Services

Help line/IntakeDaytime support for common

problemsScreening & referralsEnrollment into SFFYB

Support groupsCreation of support groups, if interest is

shownReferral to existing groups

Direct Services

Breastfeeding Education Classes

• The basics – Benefits, formula risks, cultural myths, a tradition lost

• How-to – Milk production, newborn’s needs, latching, positions, pumping, preventive measures, hygiene, care

• Lifestyle – The law, public feeding, returning to work & school, including dads & others, single parents

Direct Services

Home-Based Peer Support

• Mini-version of topics covered in classes

• Emphasis on technique

• Visits until mom feels comfortable

• Follow-up call at 2 weeks, 6 weeks

Breast pump loan program

Background• L.A. County

Cultural Barriers Soul Food For Your Baby Current Status

Today’s Outline

Current Status

In planning & development stage

Conducted many key informant interviews with positive feedback

Collaborating with Black Infant Health programs

Seeking funding

Next steps Form a planning

committee

Collaborate with more community organizations

Create/test messages in focus groups

Pilot program