Strategy. Breastfeeding Promotion Programs
Approach. Develop toolkit for providers to utilize when educating mothers on breastfeeding during perinatal care appointments
Return to main MCHbest page >>
Overview. Breastfeeding promotion programs provide education and information about breastfeeding to women throughout pre- and post-natal care, and offer counseling from health care providers or trained volunteers, and support groups for nursing mothers. Programs often establish breastfeeding policies and supports in clinical settings such as hospitals and birth centers, as well as community settings such as workplaces and child care centers. Breastfeeding promotion programs can also provide information and education to doctors, nurses, midwives, nurse practitioners, nutritionists, lactation consultants, and other health care professionals.[1]
Evidence. Scientifically Rigorous Evidence.
Strategies with this rating are most likely to be effective. These strategies have been tested in multiple robust studies in a variety of populations and settings with consistently positive results, both on their own and in combination with other strategies. (Clarifying Note: The WWFH database calls this "scientifically supported evidence").
Access the peer-reviewed evidence
through the MCH Digital Library or related evidence source.
(Read more about understanding evidence ratings).
Source. What Works for Health (WWFH) Database (County Health Rankings and Roadmaps)
Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):
- Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
- Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
- Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.
Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).
Intervention Level. Community-Focused
Examples from the Field.
Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).
|
Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")
- Number of providers trained on using the breastfeeding education toolkit. (Measures the reach of training efforts to equip providers.)
- Number of perinatal care appointments where the breastfeeding toolkit is utilized. (Tracks the frequency of toolkit use in relevant care settings.)
- Number of community partners engaged in developing or disseminating the toolkit. (Assesses level of community collaboration in toolkit creation and distribution.)
- Number of mothers who receive breastfeeding education via the toolkit during perinatal care. (Quantifies the number of women directly benefiting from the intervention.)
- Number of providers reporting increased knowledge and skills in breastfeeding counseling after toolkit training. (Evaluates the toolkit's impact on provider competency.)
- Number of mothers who initiate breastfeeding following exposure to the toolkit education. (Links toolkit usage to a key short-term behavioral outcome.)
|
Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")
- Percent of obstetric and pediatric providers trained on the breastfeeding toolkit. (Measures saturation of training across relevant specialties.)
- Percent of perinatal appointments that include breastfeeding education using the toolkit. (Assesses consistency of integrating toolkit into routine care.)
- Percent of toolkit training and education materials reflecting input from racially and culturally diverse families. (Evaluates cultural relevance and inclusivity of toolkit content.)
- Percent of mothers who report the toolkit education met their linguistic and literacy needs. (Assesses the accessibility and understandability of toolkit information.)
- Percent of providers who feel more confident in educating mothers on breastfeeding after using the toolkit. (Measures perceived impact on provider self-efficacy.)
- Percent of mothers exposed to the toolkit who report intent to breastfeed. (Captures a key attitudinal precursor to breastfeeding initiation.)
|
|
Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")
- Number of community locations outside of clinics where the breastfeeding toolkit is distributed. (Tracks community penetration of toolkit dissemination.)
- Number of local health coalitions or improvement initiatives that incorporate the breastfeeding toolkit. (Assesses integration with existing public health efforts.)
- Number of toolkit trainings that incorporate maternal mental health education and resources. (Captures linkages between breastfeeding and other MCH priorities.)
- Number of mothers assisted by toolkit-trained providers who breastfeed for at least 6 months. (Measures impact on breastfeeding duration, a key outcome.)
- Number of providers using the toolkit who report improved patient communication and counseling skills. (Assesses broader benefits to patient-provider interactions.)
- Number of women at high risk of breastfeeding difficulties who receive toolkit education and support. (Evaluates success reaching mothers most in need of breastfeeding assistance.)
|
Quadrant 4:
Measuring Quality of Effect ("How are they better off?")
- - Percent of mothers in the community who are aware of the breastfeeding toolkit resources. (Measures community saturation and visibility of the toolkit.)
- - Percent of community partners engaged in toolkit development and training who serve high-need populations. (Assesses strategic engagement of partners serving at-risk groups.)
- - Percent of provider toolkit training that includes implicit bias education related to breastfeeding counseling. (Evaluates promotion of equitable care practices.)
- - Percent of low-income women in the community who breastfeed exclusively for 6 months after toolkit implementation. (Assesses equity impact on a priority population.)
- - Percent reduction in racial disparities in breastfeeding initiation and duration compared to pre-toolkit baseline. (Measures progress toward health equity aims.)
- - Percent of mothers who receive toolkit education and report high satisfaction with their breastfeeding experience. (Links toolkit interventions to overall maternal wellbeing.)
|
Note. When looking at your ESMs, SPMs, or other strategies:
- Move from measuring quantity to quality.
- Move from measuring effort to effect.
- Quadrant 1 strategies should be used sparingly, when no other data exists.
- The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.
Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.
References
1 Centers for Disease Control and Prevention (CDC). The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta: US Department of Health and Human Services (US DHHS); 2013.
