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Running head – Week 3 Assign: Draft Introduction, Needs Assessment and Objectives

Topic

Breastfeeding Promotion

Names

Name of Institution

National University

Professor

Cheri Hoolihan

Introduction

Breastfeeding is an important element in the growth and development of a child, it provides unmatched health benefits for babies. It is considered as the clinical gold standard for infant feeding and nutrition, with breast milk uniquely tailored to meet the health needs of a growing baby. According to US Department of Health and Human Services, when you breastfeed a baby, you have given that baby a healthy start to life which can last for lifetime (US DHHS, 2019). Breastfeeding is the best source for nutrients, and in also reducing the risk for certain health conditions that can possibly affect both infants and mothers. Study has shown that low rates of breastfeeding add more than $3 billion a year to medical costs for the mother and child in the United states (CDC, 2020).

Breastfeeding promotion program is an effective tool to provide education and information to women especially new mothers, 29 and younger, throughout pre-, and post-natal care. It can help reduce obstacles that make breastfeeding particularly challenging for women of color and low-income earners and can break or reduce the disparities in breastfeeding rate and breast cancer risk existing between black and white (Anstey, 2017), as study has shown that black infants are 15% less likely to have ever been breastfed than white infants (CDC, 2020). Research has shown that there are so many health benefits for a baby and mother that breastfeeding provides, but it will be difficult in today’s hurried world to manage breastfeeding. Therefore, combining breastfeeding education and interpersonal support especially among women 29 years and younger can increase breastfeeding rates, and especially when women’s partners or family are involved (CHRR, 2018).

Need Assessment and Risk Factors

Need Assessment:

A need assessment for breastfeeding for new mothers 29 years and younger. In the United States study show that breastfeeding rates are rising; however, they continue to remain below the World Health Organization (WHO) and Healthy People 2020 goals (Kenny, L. A, 2019). Approximately 81% of mothers initiate breastfeeding, 50% are breastfeeding at six months, and 30% continue to breastfeed some at one year; however, exclusive breastfeeding rates are under 20% at six months of age (Kenny, L. A., 2019). The first 1000 days of a child’s life (9 months of pregnancy plus the first 2 years of life) is considered as crucial period, they are vulnerable during this period in terms of morbidity and mortality, malnutrition, gastroenteritis, and respiratory tract infections (Hassan, A. A, 2018). Early initiation of breastfeeding promotes exclusive breastfeeding by enhancing bonding, increasing the likelihood of breastfeeding success, and generally extending breastfeeding duration (Hassan, A. A., 2018).

Genetic Risk Factor:

The lack of breastfeeding can result to many genetic issues that can affect not only the baby, but the mother as well. A recent meta-analysis by the Agency for Healthcare Research Quality reviewed evidence of such risk, indicating that infant not being breastfed is associated with an increased incidence of infectious morbidity, including otitis media, elevated risk of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome (SIDS) (Steube, A., 2009). For mother, failure to breastfeed is associated with an increase incidence of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, and the metabolic syndrome (Steube, A., 2009).

Behavioral Risk Factor:

Studies have shown that breastfeeding has a positive influence on a child’s behavioral, physical, and mental development. Mother-infant bonding via early skin-to-skin touch, eye contact, and cradling during breastfeeding can create more secure attachment in infants, despite of shared environment and genetic, thereby reducing the risk of future externalizing behavior problems (Girard, L. C., et al 2018). Breastfeeding is essential for brain development, the nutrients found in breast milk have been shown to positively impact on white matter growth, and abnormalities in white matter have been implicated in studies which children who exhibit conduct or behavior problem. According to research, children who are less breastfed have the tendency to develop behavior problems like Attention-deficit hyperactivity disorder (ADHA) and other behavioral problems in childhood (Park, Subin., et al. 2014), compare to children that are breastfed. Also, borderline personality disorder (BPD) which is characterized by a pattern of intense but unstable interpersonal relationships, is a behavior problem which is being caused by lack of breastfeeding (Schwarze, C. E., 2015).

Environmental Risk Factor:

Environmental risk factors are factors or behaviors in our communities like smoking and drinking that especially new mothers, 29 years and younger get involved in that can affect breastfeeding. The rise in smoking rates among young women has implications for children’s health, and women especially when young, uneducated, and unsupported, who are smokers constitute a risk group for abandoning breastfeeding (Dorea, J. G., 2007). Women are strongly encouraged to breastfeed but women who smoke are more likely to have a lower milk supply, and those who do breastfeed tend to wean their babies earlier than women who do not smoke. Studies indicate that smoking more than 10 cigarettes per day decreases milk production and alters milk composition. Furthermore, breastfed babies whose mothers smoke more than 5 cigarettes daily exhibit behaviors like colic and crying that may promote early weaning (Mennella, J. A., et al., 2007). Nicotine and other chemicals from the tobacco are transferred into the breast milk at relatively high levels. The amount of nicotine to which the infant is exposed depends on the number of cigarettes consumed by the mother per day and on the time interval between the last cigarette and the beginning of breastfeeding. Therefore, it is important to educate young women on these risks, also provide support system.

Program Focus

The breastfeeding promoting that will be implemented is called ‘Women, Infants, and Children Breastfeeding program’ (WICBP). This program will be implemented at the Rady Children Hospital in San Diego for six months, and program is intended to help every step of the way, no matter what stage of the breastfeeding journey a new mother is. During the six months, new mothers 29 years and younger will attend breastfeeding classes and seminars, that will include presentation and interaction sessions with a nutritionist and Nurses, to help increase knowledge.

Program Goal, Objectives, and Interventions

Goal Statement:

· To promote inclusive breastfeeding among women especially new mothers age 29 and younger in San Diego county.

Process Objective:

· Prior to program implementation, program planners will request authorization from Rady hospital executive to implement the WICBP program.

· Before beginning the program, the program planners will contact a nutritionist to give a lecture on the nutritional value of breast milk to babies compare to formulas.

· Before the start of the program, the program planners will contact a public health nurse to teach on the health benefits of breastfeeding to both the mother and the infant or baby.

Reference

1). US DHHS (2019), Making the decision to breastfeed. Retrieved from https://www.womenshealth.gov/breastfeeding/making-decision-breastfeed

2). CDC (2020), breastfeeding. Retrieved from https://www.cdc.gov/breastfeeding/about-breastfeeding/index.html

3). country health ranking & roadmaps (2018), Breastfeeding promotion programs

4). Kenny, L. A. (2019). A needs assessment for breastfeeding students in higher education in the state of kansas (Order No. 27666750). Available from ProQuest One Academic. (2389213391). Retrieved from https://nuls.idm.oclc.org/login?url=https://www-proquest-com.nuls.idm.oclc.org/dissertations-theses/needs-assessment-breastfeeding-students-higher/docview/2389213391/se-2?accountid=25320

5). Hassan, A. A., Taha, Z., Ahmed, M. A. A., Ali, A. A. A., & Adam, I. (2018). Assessment of initiation of breastfeeding practice in kassala, eastern sudan: A community-based study. International Breastfeeding Journal, 13 doi:http://dx.doi.org.nuls.idm.oclc.org/10.1186/s13006-018-0177-6

6). Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Reviews in Obstetrics and Gynecology, 2(4), 222–231.

7). Girard, G. (2018). Breastfeeding and externalising problems: a quasi-experimental design with a national cohort. European Child & Adolescent Psychiatry, 27(7), 877–884. https://doi.org/10.1007/s00787-017-1085-9

8). Park, S., Kim, B., Kim, J., Shin, M., Yoo, H. J., & Cho, S. (2014). Protective effect of breastfeeding with regard to children's behavioral and cognitive problems. Nutrition Journal, 13 doi:http://dx.doi.org.nuls.idm.oclc.org/10.1186/1475-2891-13-111

9). Schwarze, C. E., Hellhammer, D. H., Stroehle, V., Lieb, K., & Mobascher, A. (2015). Lack of breastfeeding: A potential risk factor in the multifactorial genesis of borderline personality disorder and impaired maternal bonding. Journal of Personality Disorders, 29(5), 610-626. doi:http://dx.doi.org.nuls.idm.oclc.org/101521pedi201428160

10). Dorea, J. G. (2007). Maternal smoking and infant feeding: Breastfeeding is better and safer. Maternal and Child Health Journal, 11(3), 287-91. doi:http://dx.doi.org.nuls.idm.oclc.org/10.1007/s10995-006-0172-1

11). Mennella JA, Yourshaw LM, Morgan LK. Breastfeeding and smoking: short-term effects on infant feeding and sleep. Pediatrics. 2007 Sep;120(3):497-502.

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