1 / 25

Amy Gagliardi, MA, IBCLC, RLC Community Health Center, Inc Middletown, CT December 8, 2006

Psychosocial Risk Factors for Breastfeeding Initiation and Duration in a High-Risk, Low-Income Population. Amy Gagliardi, MA, IBCLC, RLC Community Health Center, Inc Middletown, CT December 8, 2006. Mission Statement.

indra
Download Presentation

Amy Gagliardi, MA, IBCLC, RLC Community Health Center, Inc Middletown, CT December 8, 2006

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Psychosocial Risk Factors for Breastfeeding Initiation and Duration in a High-Risk, Low-Income Population Amy Gagliardi, MA, IBCLC, RLC Community Health Center, Inc Middletown, CT December 8, 2006

  2. Mission Statement Community Health Center is a private, non-profit agency providing primary health care and social services. Its’ quality health care services are available to all, and particularly to those who cannot gain access to such services elsewhere. The Community Health Center takes leadership in promoting interagency cooperation. It is based on consumer control and is committed to ensuring human rights and respecting human dignity; as such, it strives to be a voice and vehicle for social change.

  3. History Timeline – Helping Out Neighboring Communities Middletown 1972 Old Saybrook 1980 Meriden 1990 New London 1992 Groton 1994 New Britain 1995 Clinton 2001 Westbrook 2002 Norwalk 2005 Mobile dentistry 2005 Stamford 2005

  4. What The Eye Sees…

  5. 2005 In Review

  6. A Statewide Organization

  7. Medical • Pediatrics • Internal medicine • Family practice • Family planning • Breast and Cervical Cancer Early Detection Program • Asthma management program • Prenatal program • Maternal-Infant program • Behavioral Health • Child Guidance Clinic • Intensive Family Preservation • Homeless Case Management • School Based Health Centers • Medical • Behavioral Health • Community Based Services • AIDS/HIV Services • Medical Social Work • Parent Aides • Dental • Preventative • Restorative • Emergency • Women & Family Services • Family Resource Center • Homeroom After School Program • Domestic Violence Services • Battered Women’s Shelter • Eligibility Assistance • Vinnie’s Jump & Jive dance hall Services Provided

  8. What Is An IBCLC? • Board certified and registered allied health care professional • Certification exam = standardized independent assessment of knowledge and competency • Exam disciplines include: anatomy, physiology, endocrinology, nutrition, biochemistry, immunology, infectious disease, pathology, pharmacology, toxicology, psychology, sociology, anthropology, growth parameters, developmental milestones, interpretation of research, ethical and legal issues, breastfeeding equipment and technology, techniques and public health

  9. Why Promote Breastfeeding? • Healthy People 2000/2010: Breastfeeding initiation 75%, breastfeeding at 6 mths 50%, breastfeeding 12 mths 25% • AAP recommendations: Exclusive breastfeeding for 6 mths with continued breastfeeding during the 1st year and beyond • Health Benefits Associated with Breastfeeding • Disparity between general population and Low-Income groups

  10. Epidemiological Research Suggests • Human milk superior and species specific • Reduced risk/incidence of acute and chronic diseases • Infant: diarrhea, lower respiratory infection, otitis media, bacteremia, bacterial meningitis, botulism, UTI, necritizing enterocolitis, enhanced cognitive development, SIDS, chronic digestive diseases

  11. Epidemiological Research Suggests • Mother: decreased postpartal bleeding, rapid uterine involution, weight loss, increased bone density, reduced risk of certain forms of cancer including breast, ovarian, endometrial/uterine (Enger et.al, 1998, Newcomb and Dietz, 2000, National Cancer Institute), enhanced attachment (Sinusas, Gagliardi, 2001) • Economic: Decreased health care costs, reduced employee absenteeism, cost saving (AAP, Breastfeeding and the Use of Human Milk, 1997)

  12. Diabetes/Obesity • Breastfeeding protective effect against type 2 diabetes in women (Stuebe et.al, 2005, Taylor et.al, 2005). • Breastfeeding protective against obesity in children (Bogen et.al, 2004, Bergmann et.al, 2006, Grummer-Strawn, Mei, 2004)

  13. Disparity in low-Income Populations • 2001: In USA 70.1% initiated breastfeeding among all groups (Ross Labs, 2002) • 2001: 47.5% initiated breastfeeding among low income groups, 20.6% at 6 mths, 12.3% at 12 mths (CDC Pediatric Nutrition Surveillance System (PedNss), 2005)

  14. Maternal-Infant Program • Provides prenatal and postpartum care for uninsured and for income < 185% poverty leval • Serve women throughout Middlesex County • Middletown and Clinton CHC • Medical care in collaboration with Family Practice Residency Program of Middlesex Hospital • Healthy Start services including case management, care coordination and linkages, childbirth education

  15. Breastfeeding Promotion Project • October 1994 Federal Community Nutrition Grant • Prommotion of breastfeeding to low income pregnant women through the use of trained, supervised and certified peer counselors • Community outreach including provider training, community news letters, advisory committee comprised of professional and target population members • Services include breastfeeding promotion within prenatal clinic, hospital and home visits, phone consultation, breastpumps and supplies

  16. Pre-Intervention Breastfeeding Rates • Chart review revealed 29% breastfeeding initiation rate • Duration data unavailable • Agency places high value on breastfeeding • Challenges associated with the integration of a lactation professional and peer counselors within the medical setting

  17. Continuation of Project • 1 year funding • CHC commitment to continuation of services • Combination of reimbursement and grants • 9 year research project

  18. Service Delivery • Prenatal physicians/Primary Care Physicians • Maternal-Infant Program co-ordinator • Board Certified Lactation Consultant • Medical assistants • Nurse Case Manager • Peer Counselor

  19. Data Collection and Analysis • Work Study students • Collaboration with University of Connecticut Department of Psychology • Reasearch Team: Peter A Gagliardi, BA Stephanie Milan, PhD

  20. Results • T = 931 • 661 (71%) initiated breastfeeding • 361 Still breastfeeding at 6 weeks • 39% of Total number and 55% of those who initiated breastfeeding continued at 6 weeks • Rates of initiation and duration differ significantly by race/ethnicity/age/smoking and living arrangement

  21. Table 1:Factors Associated With Breastfeeding Initiation **p<.01

  22. Figure 1: Differences In Initiation and Duration By Race/Ethnicity

  23. Figure 3: Initiation and Duration Based on Living Arrangements

  24. Conclusion • Breastfeeding Promotion is an effective intervention towards increasing breastfeeding initiation and duration rates among high risk populations • Recommendation for targeted interventions for specific sub-populations

  25. Contact Informatiom • Amy Gagliardi, MA, IBCLC,RLC • gagliardi@chc1.com, gagliardia@sbcglobal.net • (860) 347-6971 x3308

More Related