Georgia's Breastfeeding Promotion Program for Low-Income Women

• Published in: Pediatrics (Evanston) 2000-06, Vol.105 (6), p.e85-e85
• Main Authors: Ahluwalia, Indu B, Tessaro, Irene, Grummer-Strawn, Laurence M, MacGowan, Carol, Benton-Davis, Sandra
• Format: Article
• Language: English
• Subjects: Breast Feeding - psychology; Breast Feeding - statistics & numerical data; Breastfeeding & lactation; Counseling; Female; Focus Groups; Food Services - organization & administration; Georgia; Health Promotion - methods; Health Services Research; Humans; Infant; Infant, Newborn; Pediatrics; Poverty; Pregnancy; Public Assistance - organization & administration; Social Support; Surveys and Questionnaires
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.105.6.e85

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. 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, hospital-based 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. PNSS data show that breastfeeding initiation increased in the Georgia WIC program from 31.6% in 1992 to 39.5% in 1996. PRAMS data conf