Engaging the community to address breastfeeding disparities for a planned media campaign

Background: Shelby County, (Memphis) Tennessee has one of the lowest breastfeeding rates in the country, with pronounced disparities among African Americans. Objective: To explore the disparity in breastfeeding, seek possible ideas for solutions from the target population, and obtain input on a planned media campaign. Methods: Focus groups were conducted in nine community settings typically serving the low-income African American population. Funding was provided by an AAP CATCH grant. IRB approval was obtained. Groups consisted of young women, men, grandmothers or teens. Results: 86 participants were represented in 9 focus groups. Age of participants ranged from 11 years to 78 years of age. The breastfeeding rate among participants was similar to the baseline “intention to breastfeed” rate noted for African Americans in the county at 40%. Common thematic barriers to breastfeeding were identified and included: embarrassment with public nursing, concern about “partying” and breastfeeding, and “just not wanting to.” A notable finding was a concern about sexuality and breastfeeding. When asked “What is the one thing we can do…?” to improve breastfeeding, participants recommended putting breastfeeding educational materials “everywhere,” including healthcare institutions, schools, churches, and even juvenile court – basically wherever mothers are likely to be. Participants also voted on selected images for the planned media campaign and suggested slogans to go along with the images. Conclusions: Barriers to breastfeeding in Memphis are similar to other areas, with pronounced, unique concerns about sexuality and partying. Involving the target population yielded specific recommendations to improve breastfeeding promotion efforts.