Informing Families During Pregnancy

As community advocates, we know that breastfeeding/chestfeeding/body feeding is critical for optimal early infant nutrition, providing essential nutrients and immune factors that support growth and development. Equitable access to unbiased support and resources during pregnancy is a vital first step to ensuring that families have the information they need to make informed decisions about infant feeding practices. However, for too many families, access to chestfeeding/breastfeeding information and resources is limited, commercially-driven, or unavailable/not equitably provided to all families in the community. Step 4 of the Ten Steps to a Breastfeeding Family Friendly Community recognizes these challenges, calling on the community to ensure that, during pregnancy, all families are receiving unbiased, non-commercial, culturally-appropriate information.

STEP 4.  During pregnancy, all families in the community are informed about the benefits of chest/breastfeeding, as well as about the risks of unnecessary formula use, and where to access support as needed. 

Ten Steps to a Breastfeeding Family Friendly Community

Measure: Non-commercial materials on this issue are distributed, in hard copy and/or online, through community and faith-based organizations, produced or approved by a breastfeeding authority (e.g., Black Mothers Breastfeeding Association, La Leche League International, Lactation Education Resources, Ready Set Baby Curriculum) or the Designating Group, reflective of the population, and culturally appropriate. Distribution may be via the health sector, local lactation support groups, or community  coalitions.

PASS if there is documentation that information has been widely distributed.

Explore how Breastfeed Durham and Breastfeed Orange NC have implemented a range of strategies to increase access to education and resources for families and healthcare providers, supporting the initiation and continuation of breastfeeding in the community. There is a little bit of history in these stories, too. We invite you to share your story…and maybe even the history…about the ways you are implementing Step 4 in your community. Reach out through our contact form.

Launch and Focus

In August 2015, the Towns of Chapel Hill and Carrboro launched a pilot Ten Steps initiative during National Breastfeeding Month to become the first Breastfeeding Family Friendly Communities. The aim was to support families to continue to breastfeed beyond the early days and weeks after leaving the hospital. Step 4 focused on ensuring the equitable distribution of non-commercial information on the benefits of breastfeeding/chestfeeding and the risks of unnecessary formula use in order to support families to make informed decisions regarding infant feeding practices. This information would be unbiased, culturally appropriate, and accessible to all members of the community, particularly those who are marginalized or more vulnerable.

Stakeholder Support

The implementation team in Carrboro and Chapel Hill looked to its stakeholders (e.g., the Orange County Health Department, the Carolina Global Breastfeeding Institute [CGBI]) for support in meeting the requirements of Step 4.

At that time, the Orange County Health Department was working towards the North Carolina Breastfeeding Coalition (NCBC) Mother Baby Clinic Award, that is based on the Baby-friendly USA Guidelines and Evaluation Criteria and includes an education component. In addition, CGBI was developing the Ready…Set…Baby! curriculum to provide culturally appropriate information for families on the importance of breastfeeding and risks of unnecessary formula use. CGBI also was offering Breastfeeding Friendly Child Care (BFCC) training and resources, in-person and online, to help childcare providers learn about the importance of chest/breastfeeding and explore ways to welcome and support lactating families in their programs.

When the Breastfeeding Family Friendly Community initiative in Carrboro and Chapel Hill expanded to include all of Orange County, the name changed to Breastfeed Orange NC and a new stakeholder, Piedmont Health Services (PHS), joined the project. PHS/WIC provides direct breastfeeding support and resources in the languages of the families in the local WIC program, as well as information about support and classes in our community.

Additional community advocates and stakeholders also were providing information to families. Breastfeed Orange NC was grateful to the work of its stakeholders. Both the importance of chestfeeding/breastfeeding and the work of local stakeholders are recognized in Town government proclamations and on the Breastfeed Orange NC social media/website.

What might this mean for your community?

1. Encourage your local health department and hospital to become stakeholders, if they are not already part of your initiative.
2. Bring together your stakeholders to review the educational resources already in your community (e.g.,  your local health department and hospital and other stakeholders in your community). Ask the team:
   • Do the resources for parents discuss the benefits of chestfeeding/breastfeeding and the risks of unnecessary formula use in a way that is right for the needs of your community**? 
   • Are the resources unbiased, culturally appropriate, and accessible to all members of the community, particularly those who may be more vulnerable? 
   • Do the resources reflect the diversity of the families in your community?
3. If the team can answer yes to those questions, you are well on your way to achieving this step! Support or promote the distribution of those resources as part of Step 4.
4. If the response to any of the questions in #3 above is no, consider working with your stakeholders and community advocates to build on their current resources to meet the Step 4 criteria.

**Your community organizations might not be ready to address the “risks of unnecessary formula use” at first. Perhaps the focus could initially be on the importance of chestfeeding/breastfeeding. Perhaps you can introduce the risks as ways they can impact successful breastfeeding (e.g., introducing formula can decrease your milk supply). The Ready…Set…Baby! curriculum offers some thoughtful phrases about the use of formula. 

Rack Cards and Translations

In 2021, Breastfeed Orange NC began working on 3.5″ x 8″ rack cards to disseminate  information about the benefits of breastfeeding and where to find support. The size of the card was intended to fit neatly into rack card holders, whether an individual holder or a larger wall-mounted holder in a business. The Breastfeed Orange NC rack cards were a team effort, created and printed in English and Spanish with the time and funding support of our stakeholders. Stakeholders and community advocates distributed the rack cards across the community in the many locations that families meet and connect, e.g., community healthcare events and festivals; local faith-based organizations; healthcare clinics and pharmacies; and community organizations. Currently, the Breastfeed Orange NC team is securing local support to translate the rack cards into other languages to better meet the needs of more families in our community.

Breastfeed Durham, BFFC’s pilot project, took its own path to Step 4: a website and newsletter, affinity coalitions that created culturally specific materials for Black, Hispanic, LGBTQ+, Asian American, and Native American families, and a community outreach program that put information directly into local businesses. Read the full story of Durham’s Step 4 work at breastfeeddurham.org.

What might this mean for your community?

1. Gather representatives from various organizations to work collaboratively to create non-commercial materials are distributed through community organizations so that families can be informed during pregnancy about the importance of chestfeeding/breastfeeding. 
2. Look to your stakeholders and other community organizations to produce and fund chestfeeding/breastfeeding-friendly resources that reflect the diversity of families in your community.
3. Explore opportunities to distribute materials online. This may take funding, and we will explore funding in the next sections.

What might this mean for your community?

1. Start where your community is and grow from there.
   • Does the community already embrace breastfeeding, chestfeeding, and human milk feeding?
   • Who are your advocates?
   • Where will you need to expand information and support?
   • Use your mailing lists, newsletters, and website to lift up the lactation resources already available in your community.
2. Use social media!
   • Seek out advocates through social media. 
   • Keep them engaged through regular contact (e.g., newsletter, emails).
   • Publicize your initiative.
3. Encourage coalitions that reflect your community.
   • Support those who already are doing the work of building support for breastfeeding, chestfeeding, and human milk feeding.
   • Seek additional advocates.
4. Funding can be a challenge! Check out local and statewide funding sources.
   • If possible, seek funding with your local Health Departments.
   • Look to individual supporters or stakeholders.
   • If you do have funding, support affinity coalitions to develop print/online materials to meet the needs of families in your community.

What might this mean for your community?

1. Seek connections with the Health Department and local healthcare leadership.
   • Participate in Health Department outreach events.
   • View your Health Department as a possible funding source.
2. If your team is able, focus some time on funding 
   • Share funding opportunities with those on your mailing list. Having a specific need, such as an outreach position, provides a focus and often a more successful response
3. If you do have funding, consider focusing some of those funds towards a community outreach position.
   • Welcome all who show an interest in the initiative.
   • Be open to the energy and spirit of community workers. It may take some time to find the right person for the role. It is worth the effort!

Step 4 of the Ten Steps to a Breastfeeding Family Friendly Community emphasizes the importance of providing families with unbiased, culturally appropriate education on chestfeeding/breastfeeding. Breastfeed Durham and Breastfeed Orange NC have implemented a number of strategies to ensure the equitable distribution of information to help families make informed decisions regarding infant feeding practices.

We encourage you to share ways that you are implementing Step 4 in your community. Reach out through our contact form.