One of the maternal, infant, and child health goals of Healthy People 2020 is to reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life. The target for this goal is 14.2% and national data for 2011 was 19.4% (Healthy People 2020, nd).
Lowell General Hospital (LGH) serves a large Asian population, representing 70% of the patients delivering at LGH in 2014. According to the 2016 Breastfeeding Report Card (CDC, 2016) the percentage of breastfeeding women in Massachusetts that introduced formula before two days of age was 16.7%. In contrast, at LGH in March 2016, there were 131 Asian mothers who chose to breastfeed their infant, and amongst these, 71% introduced formula prior to discharge. This represents a significant cultural disparity. Gaining an understanding of these women’s experiences with breastfeeding their infants and identifying facilitators and barriers to both initiating and sustaining breast feeding will provide great insight into supportive interventions that could be implemented and help reduce breastfeeding disparities.
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Purpose: The purpose of this practice improvement study is to inform stakeholders about infant feeding practices amongst postpartum Asian women (Cambodian and Vietnamese) who deliver at Lowell General Hospital. The specific aims of this study are to: 1) describe current breastfeeding and child feeding practices amongst the specified Asian population, 2) examine breastfeeding knowledge, including breastfeeding initiation and exclusivity, among this population, 3) describe barriers to breastfeeding amongst this population and lastly 4) identify factors that facilitate sustaining breastfeeding.
Methods: A purposive sample of Asian postpartum women (Cambodian and Vietnamese), > 18 years old, literate in English, who have delivered full term at LGH during a 4 month period are being recruited to participate in this project. The Iowa Infant Feeding Attitude Scale (IIFAS) modified with additional demographic questions translated in Khmer and Vietnamese will be completed within 48 hours postpartum in the hospital setting. This survey has been shown to have multiethnic reliability and validity (Lau, Htun, Lim, Ho-Lim, & Klainin-Yobas. 2016). In addition, 4 focus groups, 2 consisting of 6-8 women of Vietnamese and 2 groups of Cambodian, recruited from through six of the Obstetric/Gynecology (OB/GYN) offices in the greater Lowell area will be held to further explore factors influencing these women’s infant feeding decisions.
Results: Descriptive statistics will be used to analyze survey results. Content analysis of the focus group data and open–ended survey questions will be used to identify themes until saturation.
Conclusion: Understanding cultural influences and barriers to breastfeeding will allow potential educational interventions to be utilized that can enhance both initiation and exclusivity rates amongst Cambodian and Vietnamese women in the Greater Lowell Area. Successful introduction of culturally-based interventions can decrease the disparities for this population of infants and potentially improve health outcomes in the Asian Communities of Greater Lowell.