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Soul Food For Your Baby A breastfeeding project targeting African Americans Elizabeth Gant, MA, MPH Maternal, Child & Adolescent Health Los Angeles County 213.639.6400 egant@ph.lacounty.gov: 

Soul Food For Your Baby A breastfeeding project targeting African Americans Elizabeth Gant, MA, MPH Maternal, Child & Adolescent Health Los Angeles County 213.639.6400 egant@ph.lacounty.gov 17th Annual CityMatCH Urban MCH Leadership Conference Denver, CO • August 26-28, 2007

Today’s Outline: 

Today’s Outline Background L.A. County Cultural Barriers Soul Food For Your Baby Current Status

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

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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

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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

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The benefits are evident, but they are not equally shared across racial groups.

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One nationwide study found that African American mothers were 2.5 times less likely to breastfeed compared to Whites. Source: Forste et al, 2001

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The disparity persists in L.A. County Breastfeeding rates 2002-2003 Source: Los Angeles County Health Survey, 2002-2003

Today’s Outline: 

Background L.A. County Cultural Barriers Soul Food For Your Baby Current Status Today’s Outline

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Why? Cultural knowledge Attitudes Behaviors

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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

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A tradition lost Association with slavery Commercialization of formula Formula perceived as “normal” milk Social stigma

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

Today’s Outline: 

Background L.A. County Cultural Barriers Soul Food For Your Baby Current Status Today’s Outline

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Soul Food For Your Baby SFFYB aims to target the social beliefs and norms that hinder breastfeeding among African Americans.

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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

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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

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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

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Methods Two-pronged approach: Social marketing – to target cultural knowledge, norms and attitudes Direct services – to increase knowledge and enhance breastfeeding experience

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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

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Social Marketing Billboard displays, bus shelter ads Posters Leaflet distribution Brochure, info cards, booklets Web site Radio/TV PSAs & interviews

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Samples

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Direct Services Help line/Intake Daytime support for common problems Screening & referrals Enrollment into SFFYB Support groups Creation of support groups, if interest is shown Referral to existing groups

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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

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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

Today’s Outline: 

Background L.A. County Cultural Barriers Soul Food For Your Baby Current Status Today’s Outline

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Current Status In planning & development stage Conducted many key informant interviews with positive feedback Collaborating with Black Infant Health programs Seeking funding

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Next steps Form a planning committee Collaborate with more community organizations Create/test messages in focus groups Pilot program

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