1. Soul Food For Your Baby Educating Policy & Enhancing Breastfeeding Practice Among African Americans Elizabeth Gant, MA, MPH Maternal, Child & Adolescent Health Los Angeles County 213.639.6408 egant@ph.lacounty.gov 135 th Annual American Public Health Association Meeting Washington, D.C. November 5, 2007

2. Today’s Outline  Background L.A. County  Cultural Barriers  Soul Food For Your Baby  Current Activities  Next Steps

3. 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 Benefits of Breastfeeding

4. 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 Benefits of Breastfeeding

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

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

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

8. Cultural 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

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

10. SFYB goals  Increase breastfeeding knowledge  Breakdown cultural taboos  Increase knowledge of ways to integrate breastfeeding into work/school schedules  Increase positive attitudes toward breastfeeding  Increase initiation and duration rates

11. 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

12. 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

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

14. Social Marketing  Billboard displays, bus shelter ads  Posters  Leaflet distribution Brochure, info cards, booklets  Web site  Radio PSAs

15. Samples

17. 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 – Educate participants about their right to breastfeed, laws protecting them, self- advocacy, public feeding, returning to work & school, including dads & others, single parents

18. Direct Services  Help line/Intake  Support groups  Breast pump loan program  Home visits by peer helpers Emphasis on technique Visit within first week of discharge from hospital Follow-up call at 2 weeks, 6 weeks

19. Current Activities  In planning & development stage  Collaborating with Black Infant Health & African American Breastfeeding Alliance in L.A.  Received funding for focus groups; applying for planning grant

20. Current Activities  Photos Shoots  Breastfeeding Assessment Survey  Focus Groups

21. Next steps  Expand collaboration with community organizations  Develop curriculum  Create campaign messages & test in focus groups  Pilot program

22. Questions? Thank You! Elizabeth Gant Soul Food For Your Baby Coordinator Maternal, Child & Adolescent Health Programs 600 S. Commonwealth Ave., Suite 800 Los Angeles, CA 90005 213-639-6408 egant@ph.lacounty.gov