The First Food Friendly Community Initiative (3FCI) explores the role of “place” in breastfeeding duration and success by implementing community-generated interventions to thereby improve infant and maternal health outcomes in vulnerable communities.
Breast milk is the optimal first food and is one of life’s earliest preventative health measures with unparalleled immunological benefits to infants and proven health benefits to mothers. Increasing breastfeeding rates in communities of color has a powerful potential to shift the life-long health trajectory from as early as infancy and to reduce health disparities among infants and mothers. 3FCI utilizes a high-impact research model that combines a proprietary community assessment tool, with community-partnered curriculum development and job skills training to reduce local social stressors and ultimately to create more breastfeeding supportive communities.
The primary objective of the project, currently being piloted in targeted communities in Detroit and Philadelphia, is to create a nationally replicable model of community accreditation for breastfeeding supportive communities, that moves from “checklist” to community-sourced solutions. The innovative accreditation process is based on a four-step community engagement strategy that includes community-led information gathering followed by educating and empowering residents to execute the needed interventions in their own community by means of a paid work experience.
3FCI also uniquely recognizes that infant and maternal health and family economic security are inextricably linked. A mother’s decision to breastfeed and ability to successfully breastfeed for any meaningful duration is greatly influenced by her financial security and her hierarchy of needs. In addition, job insecurity and low wages are a chronic social stressor that contribute to poor maternal and child health outcomes, particularly among low-income families, and are often reported as a key barrier to breastfeeding specifically, and to improved community health, writ large.
As such, a key component of 3FCI process is developing the model for a community-driven curriculum and a job skills/work training component that provides demand-driven job skills training along with a paid internship conducting community health related activities that increase social support and shift cultural norms for breastfeeding at the local level. At the same time, program participants, with a priority given to pre- and postnatal mothers and fathers, are given an opportunity to receive job skills that improve their income generating ability.
The 3FCI Process
Step 1: What can we learn about this community? This pilot views the community as a source of rich knowledge and insights that simply need to be effectively leveraged to activate a community’s innate ability to save itself. Community Assessment: Recruit, train and engage community residents to conduct an environmental scan using a propriety surveying tool and provides a unique understanding of local cultural norms, key decision making influences and the specific community “touch points” that may be unsupportive to breastfeeding. A data scientist will be engaged to develop an algorithm that translates survey results into easy-to-understand community data that is reported back to the community via a local gathering.
Step 2: How do we “re-educate” the community? The pilot views the community as a critical peer in the breastfeeding ecosystem. Just as there are renewed efforts to educate physicians, other health professionals and mothers, the community itself must be re-educated on the critical importance of breastfeeding and the role of infant health in community resiliency and success. To achieve this goal, a curriculum is currently under development that uses a framework that is inclusive of dialogical and experiential learning techniques. The 3FCI community curriculum, is locally adaptable, and provides program participants with the knowledge and tools to promote infant and maternal health in their communities and provides the personal assessments and self-awareness needed for ongoing job success. The model leverages individual experiences and connections to the community into personal and community level action plans.
Step 3: Recruit and train community residents to execute community organizing and community health activities in their neighborhood via a paid work experience. Interns will attend the 2-3day community curriculum training and then begin a 4-6 week part-time, paid internship as “Community Change Agents” to execute the necessary interventions in the community, focusing on important community touch points, such as faith-based organizations, businesses, local restaurants, laundromats, fitness centers, shopping malls, public parks and public transportation authorities, to ensure breastfeeding is supported wherever mothers eat, live, play or worship. While providing education, motivation, tools and practical strategies to these community “touch points”, participants also receive additional job skills training and certifications via a local workforce development partner organization.
Step 4: Reward community with accreditation: After activities are completed and sustained, the community becomes eligible to become accredited as a First Food Friendly Community. This reward system gives communities typically operating under negative perceptions and low achievement, an opportunity to develop a new sense of pride in their community and to be recognized for their strengths instead of being identified by any weaknesses.
Researchers looked at 73 studies with a total of almost 75,000 women and found that all types of organised support could help keep women breastfeeding—either with or without other food or liquids.
Predictable, scheduled visits with healthcare professionals or trained volunteers were most helpful, and the best kinds of support might depend on a group’s location and their needs, say the review’s authors.
They highlight the fact that many mothers may stop breastfeeding before they want to as a result of the problems they encounter.
This review now includes 100 randomised controlled studies involving more than 83,246 women. The 73 trials that contributed to the analyses were from 29 countries and involved 74,656 women.
Some 62% of the women were from high-income countries, 34% from middle-income countries and 4% from low-income countries.
All forms of extra organised support analysed together showed an increase in the length of time women continued to breastfeed, either with or without introducing any other types of liquids or foods, the authors wrote.
This meant that fewer women stopped any breastfeeding or exclusively breastfeeding (moderate quality evidence) before four to six weeks and before six months. Both trained volunteers and doctors and nurses had a positive impact on breastfeeding.
New studies of different kinds of support for exclusive breastfeeding may change our understanding of how to help women to continue with exclusive breastfeeding, they say, pointing out that evidence was of moderate quality, not high.
“Characteristics of effective support include: that it is offered as standard by trained personnel during antenatal or postnatal care, that it includes ongoing scheduled visits so that women can predict when support will be available, and that it is tailored to the setting and the needs of the population group,” they write.
“Support is likely to be more effective in settings with high initiation rates. Support may be offered either by professional or lay/peer supporters, or a combination of both.
“Strategies that rely mainly on face-to-face support are more likely to succeed with women practising exclusive breastfeeding.”
BY KITTY KNOWLES 27 FEBRUARY 2017
YouMilk matches mums who do & don't lactate.
Mothers sharing milk is nothing new. Some women produce too much – others feel guilt because they produce none. Today however, New Zealander Vlad Sadovenko is bringing breastfeeding into the digital age: his YouMilk pair mothers up to help their babies live better.
His sharing economy app may currently in development, but it is already being trialled by lactation consultant and breastfeeding mums. He might not have mammary glands himself, but he’s making ‘matches’ that matter.
We spoke to Sadovenko to find out more about YouMilk…
Vlad Sadovenko: YouMilk is a social platform which simplifies the process of informal milk sharing – it’s for families who lack milk for breastfeeding and for women who have excess milk to donate.
VS: About a year ago, two of my friends became parents of beautiful healthy children, but it soon became obvious that neither of them were fully able to breastfeed due to lack of milk.
I suggested they look for an app and was surprised to find there were none for informal breastmilk sharing.
At the moment, connections within informal milk sharing communities are made primarily on Facebook groups. Usually it’s a matter of first in, first served, creating a competitive environment and disadvantaging those who do not check the pages regularly.
On top of this, if the recipient needs information about the donor, their dietary details or any other preferences, they must ask for this sensitive information directly every time. This seems unnecessarily time consuming and potentially embarrassing.
Being neither a professional in the medical field, nor a direct user of the service, I feel like I am just trying to facilitate and simplify the process.
I did not create a product based on my own vision of the problem and then dump it on the market saying – use it! It was, and still is, a collaboration between families and certified lactation consultants.
It is a controversial topic for some people, but breastmilk remains the natural first food for babies.
There is plenty of research on the benefits of using breast milk over formula: breast milk enhances sensory and cognitive development and protects the infant against infectious and chronic diseases.
Some countries allow milk to be sourced from so-called ‘milk banks’. In other cases, mothers turn to friends or relatives. With technological advances, they are more likely to to search the web for a source, bother people they barely know asking for help, constantly check sites for a reply, try to find donor next to their place and then sort out the delivery or pick up.
I want mothers who do choose to use breastmilk to feel less stressed and more confident in accessing human donor milk.
Firstly, users create free profiles listing their health, dietary and medical preferences.
Then, the YouMilk algorithm links donors and recipients based on this information, taking into account their proximity to each other. Once profiles are matched, the sharing process is as simple as booking a taxi.
Besides online observations and interviews with lactation experts, I’ve conducted surveys to learn more about what mothers feel and think, what difficulties they meet, and the features they would like to see on YouMilk.
Two beta tests with lactation consultants and breastfeeding mums helped shape YouMilk demo 3.0 – which will be released and tested next week.
During the process I got in touch with hundreds of people, and luckily I’ve got a private investor who is now backing me and covering development costs.
Last week I was contacted by several milk banks which were interested in YouMilk and asked if it’s possible to incorporate milk banks into YouMilk, in order to simplify the process in those countries where milk banks are already established.
In the future, I’d like YouMilk to perform as a self-sustainable service, gaining funds from donations, in-app advertising and governmental or NGO support. These could be used to provide donors with milk storage bags and to maintain and improve the service.
To launch the app and spread it globally.
The way we nourish our babies will inevitably affect the next generations, so at the risk of sounding overly ambitious, I would say: YouMilk could help to change our future in a positive way.