Georgia PRAMS WIC breastfeeding data summary

Georgia PRAMS WIC Breastfeeding Data Summary

September 2017

What is
PRAMS
The Pregnancy Risk Assessment Monitoring System (PRAMS) is a joint research project between the Centers for Disease Control & Prevention (CDC) and the Georgia Department of Public Health (DPH). PRAMS collects information to improve the health of
mothers and babies in Georgia.
What is
WIC
The Women Infants and Children (WIC) Supplemental
Nutrition Program is a federally-funded health and nutrition program for infants and children age 1 to 5 years and for
low income pregnant breastfeeding and
postpartum women.

INTRODUCTION
This fact sheet provides information regarding breastfeeding among Georgia PRAMS respondents who participated in the Georgia WIC Program compared to non-WIC Georgia PRAMS respondents. It describes the importance of breastfeeding current Georgia policy regarding breastfeeding in public and at work and data on breastfeeding initiation and cessation among WIC and non-WIC moms in Georgia.
IMPORTANCE OF BREASTFEEDING
Breastfeeding is one of the most effective preventive measures to protect the health of a baby1-2. Breastfeeding reduces infant mortality by protecting infants against infectious and chronic diseases and by helping infants to recover quickly from illnesses2. Additionally breastfeeding reduces the risk of ovarian and breast cancers and helps mothers to space pregnancies2. The 2013 National Immunization Survey showed that 69.2% of Georgia moms initiated breastfeeding but only 25.4% of babies were exclusively breastfed for six months or longer3. The American Academy of Pediatrics recommends exclusive breastfeeding for six months followed by continued breastfeeding as complementary foods are introduced with continuation of breastfeeding for one year or longer as mutually desired by mom and baby4.
CURRENT GEORGIA POLICY ON BREASTFEEDING
Georgia Code states that breastfeeding is an important and basic act of nurture which should be encouraged in the interests of maternal and child health5.
GEORGIA CODE 31-1-9 BREASTFEEDING IN PUBLIC Mothers in Georgia may breastfeed their babies in any location where the mother and baby are otherwise authorized to be5.
GEORGIA CODE 34-1-6 BREASTFEEDING AT WORK Employers may provide "reasonable unpaid break time" each day to employees who need to breastfeed or pump breast milk. Break time should coincide with any break time already given to employees. Employers may provide a room where moms can breastfeed or pump breast milk in private (other than a toilet stall). Additionally employers are not required to provide break time if doing so would disrupt work operations6.
NATIONAL POLICY BREASTFEEDING AT WORK The Patient Protection and Affordable Care Act amended section 7(r) of the Fair Labor Standards Act regarding breastfeeding at work. The amended section states that An employer should provide (A) a reasonable break time for an employee to express breast milk for her nursing child for one year after the child s birth each time such employee has need to express milk and (B) a place other than a bathroom that is shielded from view and free from intrusion from coworkers and the public which may be used by an employee to express breast milk7.

References 1. CDC. (2017). Breastfeeding Promotion & Support. Retrieved August 8 2017 from https //www.cdc.gov/breastfeeding/promotion/. 2. WHO. (2017). Exclusive breastfeeding. Retrieved August 8 2017 from http //www.who.int/nutrition/topics/exclusive_breastfeeding/en/. 3. CDC. (2017). Nutrition Physical Activity and Obesity Data Trends and Maps website. Retrieved June 17 2017 from http //www.cdc.gov/nccdphp/DNPAO/index.html. 4. Eldelman A.I. Schanler R.J. Johnston M. Landers S. Noble L. Szucs K. & Viehmann L. (2012). Breastfeeding and the use of human milk. Pediatrics 129(3) e827-e841. 5. O.C.G.A. 31-1-9 (2017). Breast-feeding of baby. 6. O.C.G.A. 341-6 (2017). Employer obligation to provide time for women to express breast milk for infant child. 7. United States Department of Labor. (N.D.). Section 7(r) of the Fair Labor Standards Act Break Time for Nursing Mothers Provision. Retrieved June 16. 2017 from https //www.dol.gov/whd/nursingmothers/Sec7rFLSA_btnm.htm.

Georgia PRAMS WIC Breastfeeding Data Summary BREASTFEEDING BEHAVIOR Figure 1 Breastfeeding Behavior by WIC Status Georgia PRAMS 2012-2014
100
80

September 2017
WIC Moms Non-WIC Moms

Percentage (%)

60 44
40

20

16

35

31

53 21

0 Never Breastfed

Formerly Breastfed Breastfeeding Behavior

Currently Breastfeeding

The Relationship between Breastfeeding Behavior and WIC Status WIC moms (44%) were more likely to report never breastfeeding than non-WIC moms (16%). WIC moms (21%) were less likely to report that they were currently breastfeeding than non-WIC moms (53%). The majority of WIC moms (87%) spoke with a peer counselor or other WIC staff about breastfeeding (results not shown).

BREASTFEEDING INITIATION Figure 2 Reasons for Never Breastfeeding 1 by WIC Status Georgia PRAMS 2012-2014

Reason for Never Breastfeeding

Returned to work or school Other children to take care of
Didn t like breastfeeding Tried but it was too hard Didn t want to breastfeed

9 18
10 12 13 13 16 15

WIC Moms

Non-WIC Moms

67 42

0

10 20 30 40 50 60 70 80

Percent (%)

Note. 1Reasons for never breastfeeding omitted from this figure include "Too many household duties " "Sick or on medicine " and "Other."

90 100

Reasons for Never Breastfeeding Key Findings The top reason for never breastfeeding among both WIC moms and non-WIC moms was that they did not want to breastfeed. WIC moms (67%) were more likely to report that they didn t want to breastfeed than non-WIC moms (42%).

Georgia PRAMS WIC Breastfeeding Data Summary

September 2017

BREASTFEEDING CESSATION Figure 3 Reasons for Breastfeeding Cessation 1 by WIC Status Georgia PRAMS 2012-2014

Reason for Breastfeeding Cessation

Felt it was the right time to stop Returned to work or school
Too hard too painful or too time consuming Baby was not gaining enough weight Baby had difficulty latching or nursing
Not producing enough milk or milk dried up Breast milk alone did not satisfy baby

6 9 17 26 2109 2265 29 28

WIC Moms Non-WIC Moms
50 45
51 47

0

20

40

60

80

100

Percent (%)

Note. 1Reasons for breastfeeding cessation omitted from this figure include "Nipples were sore cracked or bleeding " "Got sick or had to stop for medical reasons " "Too many other household duties " "Baby was jaundiced " and "Other."

Reasons for Breastfeeding Cessation Key Findings About half of moms stopped breastfeeding because breast milk was not satisfying their baby (51% of WIC moms 47% of non-WIC moms)
and/or because they weren t producing enough milk (50% of WIC moms 45% of non-WIC moms). Less than 10% of both WIC moms (6%) and non-WIC moms (9%) stopped breastfeeding because they felt it was the right time to stop.

How Can Georgia Encourage Breastfeeding Among WIC Moms
By increasing availability of peer counseling services for all WIC participants While Georgia PRAMS data show that 87% of WIC moms spoke with a peer counselor or other WIC staff about breastfeeding all WIC moms could benefit from peer counseling. Evidence shows that multifaceted interventions with peer support are effective in increasing the initiation duration and exclusivity of breastfeeding7.
By improving the quality of existing peer counseling services Almost half (44%) of WIC moms never breastfed the majority (67%) of these moms stated that they did not want to breastfeed. Providing additional support for moms by increasing peer counselor contact hours improving peer counselor training and making prenatal visits earlier may help to encourage more WIC moms to breastfeed7.

By providing peer counselors with support and supervision Georgia PRAMS respondents commented on their need for access to International Board Certified Lactation Consultants (IBCLCs). Peer counselors receiving supervision and advise from IBCLCs would be able to provide additional breastfeeding expertise and support to WIC moms8.

Reference 8. CDC. (2013). Strategies to prevent obesity and other chronic diseases The CDC guide to strategies to support breastfeeding mothers and babies. Retrieved August 1 2017 from https //www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf.

Georgia PRAMS

Georgia WIC

Georgia Department of Public Health

Georgia Department of Public Health

Maternal and Child Health Epidemiology 2 Peachtree St. NW. 14th Floor Atlanta GA 30303

Maternal and Child Health Program 2 Peachtree St. NW. 10th Floor Atlanta GA 30303

Contact us at DPH-GeorgiaPRAMS dph.ga.gov

Acknowledgements

Contact us at 1-800-228-9173

Funding for Georgia PRAMS was provided by Cooperative Agreement Number 5U01DP006194-02 from the Centers for Disease Control and Prevention

(CDC). Additional support was also provided by the Georgia Title V Maternal and Child Health Block Grant.