A Community-Based Breastfeeding Intervention in Mississippi

Mississippi has high rates of preterm births, low/very low birth weights, and infant mortality. While breastfeeding can be beneficial for all babies, breastmilk and its health benefits may be most advantageous for those born preterm and at a low birth weight. Unfortunately, Mississippi’s breastfeeding rate has been one of the lowest in the nation. The Right! From the Start NICU Breastfeeding Initiative originated with the purpose of serving vulnerable babies and families through outreach and education at rural community health centers (CHCs) located in the Core and Border counties of the Mississippi Delta region and the urban neonatal intensive care unit (NICU) in the Jackson metro area

Program intervention included breastfeeding education and support for the mother while in the hospital and procurement of a hospital-grade pump at discharge coupled with transportation assistance for visits, breastmilk delivery, and appointments while their babies were still in the NICU. Teams comprised of social work, community health, and lactation specializations performed follow-up visits for support and assessments through the end of the program. This particular initiative was designed following compilation and analysis of: (1) public data to explore patterns in preterm birth and low birthweight rates at the local to state levels as well as rates of breastfeeding initiation and continuation to 6 months, (2) key-informant interviews conducted with mothers seeking care at CHCs who had given birth within the past three years concerning experiences navigating healthcare and decisions on how to feed their babies, (3) facilitation and documentation of community stakeholders and NICU initiative staff/leadership in analyzing and interpreting evaluation data, and (4) a broader survey of physicians and nurse practitioners working with NICUs across the state.

The initiative has currently served 38 mothers and 43 babies (5 sets of twins). Approximately 62% of mothers have completed their involvement in the program. Demographic characteristics of the mothers participating are representative of demographics within the Mississippi Delta region [majority African American (94%), average age of 28, single (84%), primarily unemployed (52% not looking for work and 16% actively looking for work), and with low household incomes (84% less than $20,000 in the past year)]. The babies averaged nearly 31 weeks of gestation, ranging from 23 to 37 weeks, and an average birthweight of 1,476 grams. By definition, all of the NICU intervention participating mothers attempted to breastfeed their babies, but with varying levels of success. The average days babies were provided breastmilk from their mothers was nearly 69 days (median=53, interquartile range=51), with a low of 0 days (a mother who tried but could not successfully provide milk) and a high of 271 days. Among mothers, nearly 15% were still breastfeeding at six months into their study participation. Babies whose mothers completed the program averaged longer periods of being provided with breastmilk (difference in means=59 days, difference in medians=32). Interviews conducted with 19 mothers who had completed the program tended to rate positive feelings towards breastfeeding higher and negative feelings lower.