Leruth Chelsey, Goodman Jacqueline, Bragg Brian, Gray Dara
Access Community Health Network, 600 W Fulton St, Suite 200, Chicago, IL, 60661, USA.
Matern Child Health J. 2017 Dec;21(Suppl 1):4-10. doi: 10.1007/s10995-017-2371-3.
Purpose Breastfeeding has been linked to a host of positive health effects for women and children. However, disparities in breastfeeding initiation and duration prevent many low-income and African-American women from realizing these benefits. Existing breastfeeding promotion efforts often do not reach women who need support the most. In response, the Westside Healthy Start program (WHS), located in Chicago, Illinois, developed an ongoing multilevel approach to breastfeeding promotion. Description Key elements of our WHS breastfeeding model include individual education and counseling from pregnancy to 6 months postpartum and partnership with a local safety-net hospital to implement the Baby-Friendly Hospital Initiative and provide lactation support to delivering patients. Assessment In the year our model was implemented, 44.6% (49/110) of prenatal WHS participants reported that they planned to breastfeed, and 67.0% (183/273) of delivered participants initiated. Among participants reaching 6 months postpartum, 10.5% (9/86) were breastfeeding. WHS also had 2667 encounters with women delivering at our partner hospital during breastfeeding rounds, with 65.1% of contacts initiating. Community data was not available to assess the efficacy of our model at the local level. However, WHS participants fared better than all delivering patients at our partner hospital, where 65.0% initiated in 2015. Conclusion Healthy Start programs are a promising vehicle to improve breastfeeding initiation at the individual and community level. Additional evaluation is necessary to understand barriers to duration and services needed for this population.
目的 母乳喂养对妇女和儿童有一系列积极的健康影响。然而，母乳喂养开始时间和持续时间的差异使许多低收入和非裔美国妇女无法实现这些益处。现有的母乳喂养促进措施往往无法惠及最需要支持的妇女。作为回应，位于伊利诺伊州芝加哥的西区健康起步项目（WHS）制定了一种持续的多层次母乳喂养促进方法。描述 我们的WHS母乳喂养模式的关键要素包括从孕期到产后6个月的个体教育和咨询，以及与当地安全网医院合作实施爱婴医院倡议，并为分娩患者提供泌乳支持。评估 在我们的模式实施的当年，产前WHS参与者中有44.6%（49/110）报告称他们计划进行母乳喂养，分娩的参与者中有67.0%（183/273）开始母乳喂养。在产后达到6个月的参与者中，10.5%（9/86）仍在进行母乳喂养。WHS在母乳喂养巡视期间还与在我们的合作医院分娩的妇女进行了2667次接触，其中65.1%的接触者开始母乳喂养。没有社区数据可用于评估我们的模式在当地层面的效果。然而，WHS参与者的情况比我们合作医院的所有分娩患者都要好，该医院在2015年有65.0%的患者开始母乳喂养。结论 健康起步项目是在个体和社区层面改善母乳喂养开始情况的一个有前景的途径。需要进行更多评估以了解该人群母乳喂养持续时间的障碍和所需服务。
