1. An Assessment of Mother’s Perceived Needs for Breastfeeding Support Within Our Community
Erin Eckhart MD, UTMB Pediatrics, PGY-3
Karen Shattuck, MD, Professor, UTMB Pediatrics/Neonatology
Abstract
Many mothers who initiate breastfeeding face unexpected difficulties causing them to stop breastfeeding within the first several weeks. A survey was developed in order to assess the initiation rates of breastfeeding within our community, as well as the rates of breastfeeding cessation in the early weeks and reasons for cessation. Mothers were also asked to identify specific resources in our community to better support their breastfeeding goals. Mothers bringing their infants to the 2-Week or 2-Month Well Child Check were identified and asked to fill out an anonymous survey about infant feeding practices. Fifty-four surveys were collected from which we identified breastfeeding initiation rates to be 80%. However, at the 2 week visit, mothers doing any breastfeeding dropped to 64% (32% exclusive breastfeeding) and at the 2 Month Visit to 35% (21% exclusive breastfeeding). The most often identified reason for breastfeeding cessation was inadequate milk supply. Amongst women who had stopped breastfeeding at the time of the survey as well as those still breastfeeding, mothers felt the most useful resource to help support their breastfeeding goals would be a Lactation Consultant available within the Pediatric clinic. As we move forward in our goal to support breastfeeding, pediatricians need to focus time during well visits on education about milk supply and adequate intake/satisfaction for the infant. In support of this goal, we should also work together to provide access to Lactation Consultants for mothers to support breastfeeding goals.
Introduction
(Background and Purpose/objectives)
Results
80% initiation rate of breastfeeding in our population
The rate of any breastfeeding dropped to 64% at the 2-Week Well Child Check and 35% at the 2-Month Well Child Check
“Not Enough Milk” was the most common reason for cessation of breastfeeding in mothers surveyed
59% of women surveyed were interested in participating in a breastfeeding mother’s support group
Benefits of breastfeeding are well established for both infants and mothers.
Healthy People 2020 has established breastfeeding as a national priority. The goal is to increase exclusive breastfeeding rates at 6 months from 43 to 60% and at 12 months from 23% to 43%.1
Breastfeeding rates are not available for Galveston County, but they likely fall below these goals. Many new mothers initiate breastfeeding, but stop within the first few weeks due to problems with latch, milk supply, and/or difficulty finding the support to help them adequately overcome these problems.2,3
A Community Access to Child Health (CATCH) Grant was obtained from the American Academy of Pediatrics (AAP) to fund the planning and formation of a community coalition to research local resources.
As the first step towards formation of the coalition, we need to better understand our local rates of breastfeeding and mother’s perceived needs for support within our community.  .
Description of intervention/study
Study was conducted during a 2-week period between 2/17/2014-3/4/2014
Mothers aged 18 or above who presented to the clinic with their infant for the 2-Week or 2-Month Well Child Check were asked to participate in an anonymous survey about infant feeding
Survey asked mothers to identify how they were feeding their infants: breastmilk, formula, or both
Mothers who were not currently breastfeeding were also asked if they initiated breastfeeding and if so why they had stopped
As well, mothers were asked to identify what resources within the clinic/community would help them reach their breastfeeding goals and if they would be interested in participating in a breastfeeding support group
Results were collected for a frequency analysis
BASIC DEMOGRAPHICS OF
SURVEY PARTICIPANTS
Number
Percent
Age of Mother
(n=54)
18-20 10
19%
20-29 28
52%
30-39 15
28%
40+ 1 2%
Race of Mother
White 25
46%
African-American 7
13%
Hispanic/Latino 18
33%
Asian 3 6%
Other
Number of Other Children 13
24% 21
39%
2 or More 20
37%
Number of Other Children Who Mother Breastfed 24
44% 19
35% 11
20%
Check-Up
2 Week 22
43%
2 Month 29
57%
Conclusions
As anticipated, a majority of mothers within our practice initiate breastfeeding. However, these numbers drop significantly at the 2-Week Well Child Check and even further at the 2-Month Well Child Check.
The main reason listed for breastfeeding cessation is insufficient milk supply. As such, an emphasis should be placed on discussing expectations for milk supply prior to discharge from the hospital and at the 2-Day Well Child Check after discharge from hospital.
Mothers who had stopped breastfeeding, as well as those who were still breastfeeding, listed a Lactation Consultant in Clinic to be the most useful resource to support their breastfeeding goals.
Pediatricians in our community should advocate for better availability of outpatient Lactation Consultants to help mothers early on with breastfeeding concerns/problems. By doing so, we likely could increase the rates of breastfeeding in our community.
References
Healthy People 2020 Objectives for Maternal, Infant, and Child Health: Infant Care. Available:
Wagner EA, Chantry CJ, Dewety KG, and Nommsen-Rivers LA. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics. 2013; 132, 4: e865-e875
Li RW, Fein SB, Chen J, Grummer-Strawn LM. Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics. 2008; 122(suppl 2):S69–S76
Texas Pediatric Society Electronic Poster Contest