Preventing Health Disparities by Promoting Breastfeeding Among Oklahoma Native Americans

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Preventing Health Disparities by Promoting
Breastfeeding Among Oklahoma Native Americans

• Karen K. Palumbo, MEd
• Research Project Coordinator
• Piers R. Blackett, MD, Elisa T. Lee, PhD, Dana
  Campbell-Sternlof,
• Heather Hoffhines, Kelleigh Dean, Stephen Glore
• Prevention of Obesity in Early Childhood
• Oklahoma Native American EXPORT Center
• University of Oklahoma Health Sciences Center

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Disclosure Statement
I do not have any financial arrangements or
affiliations with any corporate organizations
that might constitute a conflict of interest with
regard to this continuing education activity.
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Prevention of Obesity in Early Childhood

• Goal Explore strategies to prevent overweight
  and obesity in infants young children by
  promoting breastfeeding and healthy feeding
  practices.
• Infant Feeding Survey
• Intervention Study

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Infant Feeding Survey

• Interview/Survey of mothers and/or caregivers on
  prevailing past nutrition practice of 100
  toddlers aged 12 to 35 months
• Data collected was compared to the Feeding Infant
  and Children Study (Mathematica, 2002)

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Caloric Intake for Percentile of Energy
Requirement for Age (12-36
months)
Kcals
Percentiles of Energy Requirements
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Toddler Consumption of Energy-dense Foods
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Infant Feeding Survey

• Breastfeeding initiation rate for babies born
  at the Lawton Indian Hospital was 52, and an
  overall rate of 59.

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Infant Feeding Survey
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Infant Feeding Survey
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Conclusions from Survey

• Breastfeeding initiation/duration rates are
  suboptimal
• Low daily intake of vegetables, fruits, and milk
• High intake of calorie-dense, low-nutrient foods
• Daily energy intake above recommended
• Estimated Energy Requirements

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Intervention Study
Pregnant Native American and Alaskan Native women
are recruited to participant in a two-year
study. The study promotes breastfeeding and
healthy feeding practices for infants and
toddlers.
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Intervention Study
Current recruitment 186 mothers 139 mothers
have given birth to 144 babies (5 sets of
twins) 129 babies have been breastfed for an
initiation rate of 89.6
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Intervention Study

• Expectant mothers, and their family members,
  attend a one-time class during pregnancy.
• To date, 42 Baby Feeding classes have been
  offered, and 112 mothers and 45 guests have
  attended.

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Intervention Study

• Class topics include
• Benefits of breastfeeding for mothers
• Benefits of breastfeeding for babies
• Demonstrations of positions and latching
  techniques
• Discuss breastfeeding myths, challenges and
  problem-solving treatments

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Intervention Study

• Breastfeeding initiation rate for babies born at
  the LIH for Pilot study participants is 94,
  compared to 52 in the control group. The
  overall rate is 89 up from 59.

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Intervention Study
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Baby Study Challenges

• Maternal ages very young at 13 years and the
  average age is 24
• Lack of family support
• Lack of confidence in breastfeeding
• Phone service and transportation

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What can be done to encourage breastfeeding?
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The U.S. Preventive Services Task Force

• recommends structured breastfeeding education
  and behavioral counseling programs to promote
  breastfeeding

The Guide to Clinical Preventive Services, 2005
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Provide Accurate informationConsistent
informationBefore conception, and continue
through babys first year and beyond
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Insure thatBirth Setting PracticesareSupport
ive
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Recognize and Address the Womans Concerns
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Mothers frequently give up breastfeeding in the
learning stages because they have little
information, guidance and support.
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Provide and refer forfollow-up care to manage
challengesto preserve Breastfeeding
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Express Confidence
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Lactation ConsultantsBreastfeeding
EducatorsWIC Clinicscan assist withTime
IntensiveChallenges
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Medications while Breastfeeding
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Breastfeeding should be continued for at least
the first year of life and beyond for as long as
mutually desired bymother and child. AAP
Policy Statement, 2005
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Complementary foodsrich in ironshould be
introduced around 6 months of age.(Range of
4 to 8 Months) AAP Policy Statement, 2005
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The Cost of Not Breastfeeding

• U.S. families spend 2 billion a year on formula
• 1.3 billion spent to cover sick-child visits and
  Rx for respiratory infections, ear infections,
  and diarrhea

The United States Breastfeeding Committee, 2002
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Breast milk is

• FREE

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Although breastfeeding is natural, it is not
instinctive, it must be learned
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A good breastfeeding relationship takes time.
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A newborn baby has only three demandswarmth in
the arms of its mother, food from her breasts,
and security in the knowledge of her presence.
Breastfeeding satisfies all three. Dr. Grantly
Dick-Reed
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Breastfeeding might not be the best choice for
every parent, but
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Breastfeeding is the right choice for every baby!
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I'm a lucky Baby







Mom gave me the Best
Breastfed babies participating in a study,
Prevention of Obesity in Early Childhood,
Oklahoma Native American EXPORT Center,
University of Oklahoma Health Sciences Center,
funded by the National Center on Minority Health
and Health Disparities of the National Institute
of Health
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Acknowledgments
National Center on Minority Health and Health
Disparities of the National Institutes of
Health Lactation Consultant ServicesTM Wichita/Cad
do/Delaware WIC USPHS Lawton Service Unit
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Resources

• U.S. Department of Health and Human Services
  Office on Womens Health
• U.S. Library of Medicine, NIH
• American Academy of Pediatrics
• American College of Obstetricians and
  Gynecologists
• WHO/UNICEF

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Resources

• www.bflrc.com
• www.4woman.gov
• www.womenshealth.com
• www.motherfriendly.org
• www.lalecheleague.org
• www.babymilkaction.org
• www.childbirthgraphics.com