Breast for Success: A Community-Academic Collaboration to Increase Breastfeeding Among High-Risk Mothers in Cleveland

COMMUNITY POLICY BRIEF

What Is the Purpose of this Study?

• • To use a community-based participatory research approach for the development of a targeted intervention, Breast for Success, that supports breastfeeding among high-risk inner-city African American mothers in Cleveland, Ohio.

• • To identify specific intervention components that increased the chances (odds) of a mother breastfeeding at 1 month postpartum.

What Is the Problem?

• • Rates of breastfeeding initiation, exclusivity and duration are low among inner-city African American mothers, creating a major health disparity with impact on health and birth outcomes.

• • Barriers to acceptance of breastfeeding in the target population are multi-determined.

• • Failure of “top-down” approaches suggests that home-delivered, culturally competent, community-based interventions must be explored.

What Are the Findings?

• • Community involvement was the cornerstone of intervention implementation, with programming anchored on Cleveland Department of Public Health MomsFirst Project community health worker home visits.

• • The odds of any breastfeeding at 1 month were increased by community health worker-delivered curricular modules and lactation counselor-delivered postpartum home visiting; the odds of exclusive breastfeeding were increased by lactation counselor-delivered postpartum home visiting.

• • The educational program (modules) continues at the partner organization and as a state-funded curriculum for community health workers in the Ohio Infant Mortality Reduction Initiative.

Who Should Care Most?

• • Local and state partners who seek to increase breastfeeding rates and reduce breastfeeding disparities across diverse populations.

• • Community organizations, hospitals, and professionals who serve high-risk African American expectant mothers.

Recommendations for Action

• • Educate other Healthy Start funded and community organizations serving inner-city predominantly African American mothers about successful Breast for Success program components (free at www.uhhospitals.org/macdonald/health-and-wellness/pregnancy-resources/lactation-services/breast-for-success).

• • Continue community–academic partnership to develop additional culturally competent interventions to promote breastfeeding in the target population.

• • Collaborate to identify local and national funding to support these initiatives.