Breastfeeding and the Health Belief Model

unnamedWe know that infant feeding has a huge, long lasting impact on public health. Health education and health promotion doctoral student Erin M. Patenaude, MS, RD, LD, CLC recently attended and presented at the American Public Health Association’s (APHA) 142nd Annual Meeting and Exposition. Patenaude’s poster presentation was entitled Increasing Breastfeeding Initiation, Duration and Exclusivity Among Low-Income, African-American Women Using the Health Belief Model.

“…I was pleasantly surprised by the amount of interest in, not only my work, but breastfeeding research initiatives as a whole,” she says.

In January, Patenaude will present Health Belief Model Based Breastfeeding

Education and Promotion Program Strategies to Increase Breastfeeding Initiation Among Low-Income African American Females at Healthy Children Project’s 21st International Breastfeeding Conference.

This week, she joins us on Our Milky Way.

Q: How did you become interested in maternal child health?

A: While I was completing my Master’s Degree and dietetic internship at The University of Alabama I took a course in Advanced Community Nutrition. We had to complete a group project that looked at a health initiative listed in Healthy People 2020 and compare the status of that health issue in Alabama to the projected goal.  After narrowing down the topics, we decided on breastfeeding.  After diving into the literature and statistics on breastfeeding, or lack thereof, in Alabama I saw an area of opportunity that none of my peers saw at the time.  When I decided to stay at Alabama and pursue my PhD in Health Education and Health Promotion, I had this weird instinct that infant feeding practices had to be my research area of focus.  No one else at The University focused in that area and I wanted to be the one to blaze a new trail, not just at The University, but within the local Alabama community.

Q: What inspired you to become a CLC?

A: I dedicated my first year of PhD work to learning as much as I could about breastfeeding and the research that has been completed.  One thing I kept seeing in the literature was talk of lactation counselors.  Working as a dietitian I counsel patients and clients on all types of topics from managing their disease(s) and eating well. I hoped the counseling skills I acquired in my dietetic training and work gave me a good advantage to completing the CLC training.  I also felt on one hand that having the certification would solidify me as a member of lactation support community and, on the other hand, the training would prepare me for future research and work in the community. I looked into the different types of counselors and found that taking the course with Healthy Children and sitting for the ALPP exam was right up my alley.  I even went home to Las Vegas to complete my training, which was awesome to spend time with my parents during the same time.

Q: What was the most important thing you gleaned from The Lactation Counselor Training Course?

A: I noticed that you really don’t have to have a medical or health practitioner background to excel at being a CLC.  Attending the class back in Las Vegas, I met all types of people from nurses to WIC administrators to doulas to other dietitians.  It was awesome to be in a group of people that were just as passionate about breastfeeding as I was.  The huge take away that I always tell others about is the whole concept of always praising the mother first for attempting or continuing to breastfeed despite any issues that arise (that tend to be barriers for a lot of women).  It is a concept that I now teach my dietetic students to use in nutrition counseling.  Behavior change and goal setting are a large part of what we do as dietitians and we need to take the extra few seconds to praise a person for trying a new lifestyle or diet change, whether they are successful or not.

Q: Some of your research focuses on the attitudes and beliefs on breastfeeding among African American women in the Southern states. What has surprised you most about this research? How do you hope your research will be used?

A: What has surprised me the most about research done on multiple health issues in Alabama and surrounding states is that this area of country is very different from the rest of the US. Programs and initiatives that may work in African American populations in Maryland or California do not necessarily work down here.  A lot of work needs to be done to tailor and validate programs and research interventions to fit the African American population in the South.

I hope that my research will open people’s minds to the use of health theory to build breastfeeding initiatives and programs for all women.  I also hope to shed more light on breastfeeding as an economical infant feeding practice within the African American community here in Alabama in hopes that more women would want to at least try breastfeeding before making a final infant feeding decision.

Q: Do you see a need for legislative policy change to better reflect the needs of breastfeeding mothers? If so, what kind of changes would you like to see?

A: There has been great strides in legislative change in recent years regarding protecting mothers who breastfeed in public, but the amount of policy and laws are not consistent state-to-state.  It really starts at the state level and residents of each state who are passionate about breastfeeding need to reach out to their local congresspersons. Politics are an intense subject and I could probably talk all day about it, so I am just going to say – GET INVOLVED AND SPEAK UP! I always tell my students, “Nothing ever changes, if nothing ever changes.”

Q: What concerns you most about the low breastfeeding rates in your area? Can you please explain how you see infant feeding fitting into the greater public health of our country?

A: I would hate to see breastfeeding fall off the radar with more and more advances in food science and technology that can create just about any tailored formula you can think of.  The connection between breastfeeding and improved health later in life for the child is not expressed to the public as strongly as it should.  We see low numbers of breastfeeding initiation and higher numbers of childhood obesity, Type II diabetes and other chronic diseases diagnosed each year.  As a dietitian and now CLC, both sides of that spectrum affect me as health professional.  I see a clear way to try to reduce the incidence of chronic diseases through breastfeeding, we just have to constantly and consistently educate the public that good health choices in the first few years of life could impact a child’s entire future.

Q: Are you optimistic about the future of maternal child health? Why or why not?

A: Very much so! There is a large movement of health professionals and general population that care a lot about maternal and child health.  Those interested in health research are seeing this as a great area to not only expand the pool of research, but to genuinely do some good for mothers, children and families.

Q: What are you most looking forward to at the International Conference in January?

A: I am looking forward to meeting a lot of other people who are passionate about breastfeeding. I can’t wait to share my ideas for the future of research in breastfeeding and absorb others ideas and personal accounts as well.  This will be the first conference I have attended that will focus solely on breastfeeding and I can’t wait to share all that I will learn with my students and colleagues upon my return.

Q: Anything else to add?

A: I always tell my students that what I do gives me the “warm and fuzzies” which further inspires me to continue to do more and more with breastfeeding. Picasso is quoted as saying, “The meaning of life is to find your gift. The purpose of life is to give it away.”  I can honestly say I have found my gift as a CLC and continue to cultivate it through my PhD work as I strive to share my gift with mothers and children who will benefit the most from it.

Patenaude’s next round of research (currently in progress) focuses on the social cognitive theory. She is looking at all of the things that may affect a mother’s environment and in turn, might determine if she is successful at initiating breastfeeding. Stay tuned!

Register here to engage with Patenaude at the International Conference.

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