1. Increasing Breastfeeding Rates in South Hampton Roads
Rebecca Berryman, Allita De Oliveira Braga, Ayesha Howard, Gibtsawit Kidane, Leizle Ortiz, Kimberly Pullen, Emily Redden, Rosa Shu

2. Breastfeeding in the U.S.
Currently 79.2% of women initiate breastfeeding
Only 18.8% continue to exclusively breastfeed for six months
Healthy People 2020 goal for breastfeeding
81.9%
23.7%
This presentation will demonstrate why breastfeeding is important, and why programs such as “Breastfeeding Welcome Here” and “La leche league” are so important and essential in reaching the Healthy People 2020 goals for breastfeeding.

3. Breastfeeding Benefits
Infant:
Contains antibodies
Changes as the child grows
Lower risk for:
Ear infections
Diarrhea
Respiratory infections
SIDS
Asthma
Obesity
Mother:
Lower risk for:
type two diabetes
breast and ovarian cancers
postpartum depression
Increased weight loss
Decreased cost
Bonding
Society:
Less environmental waste
There are many benefits to breastfeeding. Breast milk contains antibodies which pass from the mother to the baby and help to protect them from infection. Breast milk also changes as the baby grows according to their needs at that stage of development. Babies who are breastfed have a lower risk for ear infections, diarrhea, respiratory infections, SIDS (sudden infant death syndrome), asthma, and obesity. Benefits for the mother include lower risk for type two diabetes, breast and ovarian cancers, and postpartum depression. Other benefits include increased weight loss for breastfeeding mothers as well as decreased cost. The environment also benefits from decreased waste because less bottles, nipples, and other supplement accessories are thrown away.

4. Aggregate Description
Aggregate: Mothers and Women of Childbearing Age Able to Breastfeed
Our program did not work directly with the aggregate but rather the local businesses in order to facilitate support and a welcoming environment for breastfeeding mothers.
State the health problems of the aggregate, utilizing the nursing diagnosis format, identified during the assessment phase Rosa Shu
(Only 18.8% of 6 month old infants are exclusively breastfeed)
Dissatisfaction or difficulty a mother, infant, or child experiences with the breastfeeding process
formula too much water/ diluted & doesnt contain

5. Assessment Health Problem: Low Breastfeeding Rates
Mother and child are missing the immediate and long term health benefits of breastfeeding
Nursing Diagnosis
Deficient knowledge Related to Breastfeeding
Ineffective Breastfeeding Related to Unsatisfactory Process
Less than optimal nutrition
Rosa
Less than Body Requirement

6. Breastfeeding Welcome Here
Projects
Breastfeeding Welcome Here
Increasing visual cues
cute pic em

7. Projects
Business Case for Breastfeeding
Policies for employees

8. Projects Breastfeeding Friendly Childcare
Policies for breastfeeding mothers

9. Healthy People 2020 Objective:
Increase the proportion of infants who are ever breastfed

10. Measurable Goals Sign up 40 businesses for BFWH
Survey 50% of businesses participating in BFWH
Begin advertising at Old Dominion University
Increase the number of lactation rooms at Tidewater Community College by one
Increase the number of lactation rooms at Old Dominion University by one
Increase the number of Breastfeeding Friendly Childcare training participants and centers
sign up 40 businesses between August 2014 and April 2015 for the breastfeeding welcome here program
survey half or greater of the local businesses participating in the breastfeeding welcome here program who joined before August 2014 and evaluate changes in their business after joining the program
begin advertising for lactation rooms and breastfeeding awareness at Old Dominion University
increase the number of lactation rooms at Tidewater Community College by one
Increase the number of lactation rooms at Old Dominion University by one
increase the number of childcare centers participating in the Breastfeeding Friendly Childcare training

12. Primary Intervention: Education
EDUCATION IS KEY!
social norms, lack of knowledge, limited information
Want to create spaces for breastfeeding mothers to feel comfortable in
The primary intervention is to spread knowledge about the necessity and benefits of breastfeeding to those who have a direct effect on the aggregate: this includes local business owners and their employees. It is apparent these parties base their beliefs and views on their own knowledge of the issue. A perception of social disapproval of breastfeeding in public is one of the main reasons why women may cease breastfeeding early (Marsden, Abayomi, 2012). Therefore, the need for intervention is determined by considering these parties may have an understanding of “the opposing side” and may benefit from further education.

13. Interventions CINCH: Breastfeeding Welcome Here! Project
Partner with local businesses
Sign a pledge
include standards of project, staff training, visibility of logo
CINCH: BFWH Project
-Breastfeeding Welcome Here! Project partners with employers
-Goals: increase awareness about breastfeeding
**Increase social acceptability with knowledge!!

14. Interventions Accomplishments IHOP
mother given towel to cover baby’s head
contacted and signed pledge
“Breastfeeding Sit-in”
Assistant Dean: Breastfeeding rooms at ODU
Article in Health Sciences Newsletter
-IHOP
-situation where mother was given a towel to cover up her baby’s head; became local news story
-called IHOP to set up a teaching session (??)
-“Breastfeeding Sit-in”
-trained staff, mothers sat and breastfed their children
-IHOP partnered with BFWH! Project
-Assistant Dean: ?
-advertisement for ODU placed on FB on ODU nursing page and in March Health newsletter

15. Interventions Goals: increase awareness about breastfeeding
**Increase social acceptability with knowledge!!
By serving as an advocate, and targeting local businesses, the ultimate goal of spreading education is to increase breastfeeding mothers’ self-efficacy and gradually normalize the view of breastfeeding in society.

16. So why are these projects so important?

18. Current Research
Association of Child Care Providers Breastfeeding Support with Breastfeeding Duration at 6 Months
Highlights the importance of support and the foundation of our project
Support at 3 months
Some current research that we found that supports our project is:
Support from care providers at the 3 month period was a big indicator of whether the mothers continued breastfeeding or not.
Mothers returning to the labor force require support more than other mothers because if the are not given the time to express their milk then they are most likely to discontinue breastfeeding and begin bottle feeding. Which can have significant impacts on both mom and baby.

19. Current Research
Exclusive breastfeeding: motivations and disincentives for nursing mothers in Eldorado do Sul, Brazil
Lack of support could lead a mother to discontinue breastfeeding
Some more research that really advocates for breastfeeding mother support was conducted in Eldorado do Sul, Brazil.
This research looked at the motivations and barriers to breastfeeding continuation. One of the biggest barriers was again support of the breastfeeding mother.

20. Alternative Interventions
Increasing Breastfeeding Rates: Evidence-based practice.
Question: “In low income postpartum women, how does telephone breast feeding support compared to standard care affect breastfeeding rates within a 6 month period from delivery of a term newborn?”
Method: weekly calls for the first 3 months after giving birth.
Findings: A 35% increase in the exclusive breastfeeding rate.
Source:

21. Alternative Interventions
Social marketing: Commercials that convey feelings and help with gearing people’s assumptions and opinions about a determined topic, such as breastfeeding.
The Centers for Disease Control published that television commercials were the most effective in changing attitudes towards breastfeeding and increased breastfeeding initiation (CDC, n/d).
Source:

22. Interventions: Limitations/ Barriers
Changing the norms and traditions
Breast feeding is viewed as “Improper” “indecent”
Changing personal beliefs
Some mothers who formula feed felt offended and defensive
Many were not aware of the new breastfeeding law allowing breast feeding in public places
Lacking Role models
Lack of knowledge
Lack of media encouraging breast feeding.
Describe barriers encountered during the implementation phase and how they were addressed. Rosa Shu
Many moms want to openly breast feed but feel alone or shy. If there were mothers openly breast feeding more mothers would be encouraged to as well
Some females stated concerns over their husbands seeing other female breast ome females stated concerns over their husbands seeing other female breast

23. How Were the Limitations and Barriers Addressed?
EDUCATION !!!
Teaching the benefits of breastfeeding
Acknowledge the aggregate personal feeling and beliefs
Peaceful and respectful approach
Benefits to their businesses (advertising and attracting customers)
Rosa Shu

24. Evaluation Process
Recording responses of business owners for placing sign or rejecting the sign

25. Evaluation Process
Recording responses for day care center education

26. Evaluation Process
Revisited businesses signed before August 2014

27. Evaluation Goal Met or not met Accomplishment 40 new businesses met
50% of businesses surveyed
not met
24%
Advertising at ODU
School facebook site
and Health news letter
One lactation room added at TCC and ODU
Did not add any extra rooms
Increase child care facility participants
increased to 15 participants

28. Limitations of Evaluations
Personal belief of breast feeding

29. Limitations to Evaluation
Snow!!!
Distances between
business

30. Limitations to Evaluation
Decision makers
not available and/or
not getting a response
back
Some businesses did not see the benefit
-TCC didn’t see benefit

31. Recommendations Effective communication among the students
Make sure signage is properly displayed

32. Recommendations Make day care teaching more enjoyable
Decorate ODU lactation room
New lactation room for
Health Science building

33. Recommendation Information given to new coming students
Narrow focus to fewer projects
greater results

34. Implications for Community Health Nursing
To bring awareness to community
To educate the public about benefits

35. Implications for Community Health Nursing
Make environmental
cues to encourage breast feeding mothers

37. References
Batan, M., Li, R., & Scanlon, K. (2013). Association of child care providers breastfeeding support with breastfeeding duration at 6 months. Maternal And Child Health Journal, 17(4), doi: /s
Center for Disease Control. n/d. Media and Social marketing. The CDC Guide to Breastfeeding Interventions. Retrieved from
Consortium for Infant and Child Health.Breastfeeding welcome here. Retrieved from
Flannery, V. (2014). Increasing Breastfeeding Rates: Evidence-Based Strategies. International Journal Of Childbirth Education, 29(4),
Schardosim, J. M., & Rauber Cechim, P. L. (2013). Exclusive breastfeeding: motivations and disincentives for nursing mothers in Eldorado do Sul, Brazil. Investigacion & Educacion En Enfermeria, 31(3),
Flannery, V. (2014). Increasing Breastfeeding Rates: Evidence-Based Strategies. International Journal Of Childbirth Education, 29(4),
Schardosim, J. M., & Rauber Cechim, P. L. (2013). Exclusive breastfeeding: motivations and disincentives for nursing mothers in Eldorado do Sul, Brazil. Investigacion & Educacion En Enfermeria, 31(3),