Factors that Contribute to increased Breastfeeding in the CAPC/CPNP Population

Fact Sheet 3 in a series of 5
August 2002

A Tailored Approach Meets Basic Needs

Projects that have been highly successful in breastfeeding initiation and duration among women within the focus population are those which have adapted to respond to the particular needs of their participants.

Sound Strategies

Three key factors that contribute to a successful breastfeeding strategy include:

• A continuum of strategies to deliver support

"... a continuum of strategies started early, using a holistic approach tailored to the needs of the focus population, are essential to promote, protect, and support breastfeeding." - A Think Tank participant

• Education and training

"... programs need people with specific knowledge, attitude and skills to work effectively with the focus population and the community in which they live, leading to women and families [becoming] empowered to choose to breastfeed and reach their breastfeeding goals." - A Think Tank participant

• Community enhancement

"... when communities are engaged, breastfeeding initiation and duration rates in the focus population increase." - A Think Tank participant

Where Do We Start?

Get Involved

Involvement with the mother must be maintained from first contact, with continued engagement through to closure. Holistic contact types include:

• peer and professional support
• home visits
• 24-hour telephone support line
• group and individual approaches

Keep it Simple

The appearance and ambiance of the program and its staff can determine whether or not a woman participates. Key elements include:"

• having fun
• using the language of positive images
• program visibility
• earning the trust of participants
• a family-friendly atmosphere
• informality

Disseminate Knowledge

"Under the medical model, we just give the lactation consultant the breast and the doctor the uterus, and we lose the mother in between." A Think Tank participant

• Utilize the expertise of lactation consultants to train others, including doctors and nurses who are present for the first critical 24-postpartum hours.
• Peer support, or the "buddy system", is very effective.
• Pay volunteers a wage or stipend to conduct community workshops.
• Facilitate ongoing training and make resources readily available.

Create Linkages

"We had some complaints from a restaurant that there was breastfeeding going on, so of course that's the restaurant we brought our big group to and we all breastfed there." A Think Tank participant

"People need to have a little positive acknowledgement; they get lots of negative. If I see a woman breastfeeding this weekend, I'm going to congratulate her." A Think Tank participant

The community can protect, promote, and support a breastfeeding culture by developing working partnerships with community members such as:

• focus population
• medical
• family
• business
• media
• school

Keeping on Track

Facilitate ongoing communication centered around the mother.

• Develop more trust by presenting staff less as "professionals" or experts.
• Offer practical support to participants in programs who are breastfeeding (e.g., childcare, grocery certificates, etc.).
• Creative programming not immediately relevant to breastfeeding, such as a knitting group, can open the door for uncommitted mothers to consider breastfeeding.
• Balance and respect the different mandates of the involved community partners.
• Recognize the value of shared experience.
• Empower the mother to make informed choices rather than telling her what to do.
• Avoid stigmatized terms such as "teen mom". Instead, use "young parent."

"Try to celebrate the youth pregnancy, because nobody is doing that. These girls want to be good mothers."A Think Tank participant

Where Do We Go From Here?

Results of the Literature Review

There is an abundance of literature on the knowledge, attitudes and skills of health professionals and hospital staff with regards to breastfeeding promotion, support and protection issues. However, none of the published literature pertains to workers of community-based programs such as CPNP. There is a need for studies that address the knowledge, attitudes and skills of CPNP program workers and how this impacts rates of breastfeeding initiation and duration among the focus population.

Key Messages From the Think Tank

• An understanding of the factors that influence the feeding decisions and practices of mothers is vital to improving breastfeeding rates.
• Guidance and support in the immediate and early postpartum period are critical.
• Above all, the environment should be a "safe" one where breastfeeding is normal, valued, affirmed and celebrated. Even small breastfeeding victories should be acknowledged.

The Community Action Program for Children (CAPC) and the Canada Prenatal Nutrition Program (CPNP) support a range of community action programs and services for pregnant women, parents and children living in conditions of risk across Canada. CAPC and CPNP sponsored their first "Think Tank" in Ottawa. To ensure that the outcomes were meaningful to CAPC/CPNP projects, an Advisory committee with representation from projects, as well as regional and national Health Canada staff, designed and shaped the event.

At the Think Tank, representatives from 38 CAPC and CPNP projects came together with community- based participatory researchers to integrate their experience and expertise into four issue papers:

• Maximizing Parental Involvement
• Reaching and Maintaining the Focus Population
• Factors that Contribute to Increased Breastfeeding in the CAPC/CPNP Population.
• Partnership and Intervention in Dealing With Child Abuse Prevention

A fifth paper entitled, Colouring Outside the Lines: An Overview of the CAPC/CPNP Think Tank Process, provides an overview of the experimental model used during the Think Tank.

The key highlights of these five issue papers have also been captured in five fact sheets with the same titles. This fact sheet is the third in the series.

Production of this document by the Centre for Health Promotion, University of Toronto, has been made possible by a financial contribution from the CAPC/CPNP National Projects Fund, Health Canada.

Permission is granted to photocopy this material provided that the source is acknowledged. Full versions of the issue papers and the fact sheets are available on the Division of Childhood and Adolescence website. Hard copies of the documents can also be obtained by contacting the Division of Childhood and Adolescence at (613) 957-3956.