Reducing Disparities in Breastfeeding: "Breast for Success" Excels a Second Time.

Area of Science:

• Public Health
• Maternal and Child Health
• Health Equity

Background:

• Breastfeeding offers substantial health benefits for mothers and infants, yet significant racial disparities persist, particularly affecting African American and Black (AA/B) women due to structural racism.
• Existing breastfeeding support programs often fail to adequately address the needs of high-risk populations, contributing to lower initiation, continuation, and exclusivity rates among AA/B women.

Purpose of the Study:

• To evaluate the replicability and effectiveness of the Breast for Success (BFS) intervention in improving breastfeeding outcomes among low-income, predominantly AA/B mothers enrolled in a home-visiting program.
• To assess the impact of BFS on breastfeeding initiation, continuation, and exclusivity at one month postpartum within a real-world community health setting.

Main Methods:

• An observational study (BFS Excels a Second Time - BEST trial) was conducted, enrolling expectant mothers in the Moms and Babies First (MBF) Community Health Worker (CHW)-led home visiting program.
• Participants received the BFS intervention, comprising 11 CHW-delivered breastfeeding modules, supplies, and a postnatal lactation visit, integrated into the existing MBF program.
• Breastfeeding initiation, continuation, and exclusivity at one month postpartum were the primary outcomes measured for BEST trial participants.

Main Results:

• The study population consisted primarily of AA/B women (83%), with most living below 200% of the poverty level (95%) and being unmarried (98%).
• An exceptionally high rate of breastfeeding initiation (98%) and continuation at one month postpartum (98%) was observed among participants.
• Exclusive breastfeeding at one month postpartum was achieved by 91% of the participants.

Conclusions:

• The Breast for Success (BFS) intervention is highly effective and seamlessly integrates with existing CHW-led home-visiting programs, significantly boosting breastfeeding rates in high-risk populations.
• BFS addresses a critical gap in breastfeeding support, demonstrating its potential to mitigate racial inequities in breastfeeding and improve maternal and child health outcomes.