A Coordinated Cultural Shift Improves Breastfeeding Exclusivity in a Federally Qualified Health Center [16E

Abstract

INTRODUCTION: Provider support for breastfeeding has been shown to have a positive impact on breastfeeding including initiation and continuation. This study attempts to determine if a coordinated cultural shift can influence breastfeeding rates among patients in a Federally Qualified Health Center (FQHC). METHODS: All staff at Eric B. Chandler Community Health Center, an FQHC located in an urban setting in New Jersey, were educated about the importance of breastfeeding and improved outcomes in breastfeeding mother-baby pairs. Additionally, key staff members were trained to assist with breastfeeding problems. Breastfeeding promotion was standardized within the obstetric program. A professional relationship with WIC was established. Data was collected and analyzed to determine if there was an impact on breastfeeding at the six-week postpartum visit comparing the six months prior to and six months after the cultural shift. RESULTS: Three hundred seventy-three women in the post intervention group were compared to 63 women in the baseline group. Exclusive breastfeeding at six weeks postpartum increased from 12/63 (19.1%) to 107/373 (28.7%), p less than 0.05. Combination feeding decreased from 31/63 (49.2%) to 159/373 (42.6%). Exclusive formula feeding remained unchanged 20/63 (31.7%) compared to 107/373 (28.7%). Mode of delivery had no influence on rates of breastfeeding. CONCLUSION: This study demonstrates that a coordinated cultural shift can increase the rate of breastfeeding exclusivity in a FQHC. Improvement in exclusivity, however, was a result of more breastfeeding women forgoing supplementation. There was no comparable increase in formula feeders choosing either combination feeding or exclusive breastfeeding.