Researchers partner with moms to overcome breastfeeding obstacles

Aug 27 2008

The message, "breast is best" may be familiar and powerful, but it's not enough to get some women to breastfeed. A new University of Rochester Medical Center project creates a partnership with mothers who are not likely to breastfeed exclusively, and tries to improve the rates by first understanding their perspective and obstacles.

Although Rochester has various programs to promote the value of breast milk, gaps do exist among low-income women, who often face social and financial influences that work against breastfeeding, said Ann Dozier, R.N., Ph.D., principal investigator for the $2.4 million National Institutes of Health study.

For example, although breast milk is free, low-income women are also eligible to receive free formula through the Women Infants and Children (WIC) government food program. Some mothers report they get mixed messages from health care providers about the benefits of breastfeeding. Others say they find it too difficult to pump and store breast milk after returning to work.

Social pressure from the baby's father, husbands, boyfriends, female relatives and friends, who do not support their desire to breast feed, also present obstacles for many mothers, who are already concerned their babies won't get enough nutrition from breast milk.

"What's unique about this program is that as researchers, we are first gaining insight into the concerns and issues of these mothers, and then enlisting them to help us come up with ways to increase the likelihood that they will try to breastfeed exclusively," Dozier said. "This is much different from the usual route, where the researchers come up with a solution beforehand and then conduct a study to see if it was correct."

The five-year study is set up to gather additional information about the behaviors and experiences of approximately 3,600 women. Researchers are following initiation rates, duration, and how many women reach the goal of exclusive breast feeding for six months.

Six months is believed to be an optimal length of time to achieve the maximum benefits of breastfeeding, such as protection against asthma, allergies, ear infections and other childhood illnesses. The American Academy of Pediatrics reports that breast milk offers economic, developmental and psychological advantages in addition to the health benefits. Early data show that women respond positively to the message about benefits for the baby, and therefore reinforcing it will be critical, researchers said.

"We are determined to make inroads and demonstrate real strategies that women can use," added Dozier, associate professor,Division of Social and Behavioral Medicine in the Department of Community and Preventive Medicine. "We know that breastfeeding works, and that mothers and fathers want what's best for their babies. Our goal is to identify what a new mother needs for success and how that can be provided.

August is National Breast Feeding Awareness Month. Statistics show that when asked about their intentions to breastfeed exclusively after being discharged from the hospital, the rates vary among income groups. For example, in Monroe County in 2007, about 71 percent of all women who delivered a baby reported that they intended to feed their babies exclusively with breast milk. However, when statistics are sorted by income groups over the period of 1999-2006, the breastfeeding rates were significantly higher among those with higher incomes (74 percent) compared with mothers who reported a lower income (57 percent), according to URMC project leaders and the Monroe County Department of Health.

Several community partners are working with the University of Rochester team. They include the Perinatal Network of Monroe County (PNMC), which has the primary responsibility of recruiting mothers, fathers and grandmothers for a Community Council; the Rochester African American and Hispanic Health Status Task Force; and the Center for Community Health.