Strategies for Improving Breastfeeding Rates: Perspectives of Public Health Staff

To inform development of a breastfeeding intervention for public assistance clients, we aimed, through qualitative methods, to explore public health staff members' perspectives of facilitators and barriers to initiating and continuing breastfeeding for clients and strategies to improve breastfeeding rates.

We conducted focus groups with staff from Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Massachusetts and Virginia, US, to identify strategies WIC staff use to encourage and support breastfeeding, by leveraging facilitators and overcoming barriers, to inform the development of a breastfeeding intervention. Data collection and analysis followed an iterative process using constant comparison by a diverse group of researchers with expertise in qualitative methods. Focus groups were continued until thematic saturation was reached.

51 WIC staff members participated in 7 focus groups. Themes related to strategies used to promote breastfeeding included providing education, with subthemes relating to anticipatory guidance, normalization of breastfeeding, and the importance of tailored messaging; education format, with subthemes regarding timing of education and engagement of support networks; relationship building, including subthemes of establishing rapport and sharing personal experiences; and resource provision.

WIC staff identified the importance of providing specific, concrete information about breastfeeding; strategies to breastfeed while working and caring for other children; the importance of connecting with clients to build trust; and increasing social support for breastfeeding clients. This study provided valuable information to help guide development of a breastfeeding intervention.