P3.047: Engaging the Community to Close the Gaps in Breastfeeding Disparities

Background: Breastfeeding rates have steadily increased throughout the United States, but significant disparities remain and have lasting impact on population health. Per the CDC National Immunization Survey (NIS), the lowest breastfeeding rates are found in Non-Hispanic Black and Native American populations, whereas the highest rates are found in Asian populations.

Project Description: In our county, a concerted effort has been made over the past ten years to engage the African-American community of women to become changemakers for improved breastfeeding rates and overall community health.
In 2017, we launched a collaborative Community Based Participatory Research project in a neighborhood with very low breastfeeding rates and high infant mortality. Community moms joined an academic research team to create AMEN, a Peer-to-Peer Breastfeeding Support group , (Avondale Moms Empowered to Nurse, now “All Moms Empowered to Nurse” with program expansion). Community moms trained as peer counselors to lead groups as Breastfeeding Champions. AMEN grew from 1-2 meetings per month in 1 location with 8-10 attendees, and now meets weekly on Zoom with 35-40 expecting and post-partum moms (Figure 1). Champion moms lead the groups and receive a stipend; attendees receive a small honorarium. Special guests discuss area resources important to families struggling with social drivers of health.
A second innovative community program is our Community Breastfeeding Ambassador Program (CBAP), which prepares community members to provide outreach in multiple venues. The Health Fair Outreach program gives community members the opportunity to attend health events, typically in areas with health disparities, to share breastfeeding support information. Community members also participate with the BACCS team (Breastfeeding Advocacy in Community and Cultural Spaces) to work with local businesses, childcare centers, and workplaces to achieve “Breastfeeding Friendly” status. BACCS recently developed an innovative “Breast & Rest” program to provide safe spaces for mothers to nurse during community events. A special mentoring/scholarship program provides advanced lactation training with mentoring to interested community members. CBAP also funds a community member in the leadership of the Southwest Ohio Breastfeeding Coalition (SWOBC), an organization connecting regional breastfeeding efforts. Finally, the program enhances a strong partnership between AMEN and L.E.C.H.E. (Latinas Empowered to Choose Health Excellence) culturally matched peer support groups.

Discussion: Community Partners overwhelmingly support connections with these community-based programs, and recent breastfeeding initiation data document narrowing of the gap between non-Hispanic White and non-Hispanic Black families (Figure 2). Our local village has come together: hospitals, WIC, Community Health Workers, Quality Improvement projects and many more efforts are narrowing the breastfeeding gap.

Conclusion: The community must be engaged to address breastfeeding and other health disparities; they have the energy, the focus, and the answers. The breastfeeding gap has narrowed in our region, but we still have much work to do.