Get Real About Breastfeeding Campaign

Ingham County Health Department’s new campaign, Get Real About Breastfeeding, is already gaining a lot of positive attention in the media, on social networking platforms and within the community. The Get Real About Breastfeeding initiative is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS.)

The campaign launched in early April and will run until June 2016. In collaboration with Willow Tree Family Center, Strong Start Healthy Start, Capital Area Breastfeeding Coalition, Ingham County WIC and Redhead Design Studio the campaign features billboards placed throughout the community, posters, postcards, cinema advertising, a traveling gallery, social media shareables, and its website for moms and families to access breastfeeding resources.

Greiter nurses daughter Elise.
Greiter nurses daughter Elise.

Willow Tree Family Center Early Childhood Specialist Nicole Greiter, MA comments on the importance of collaboration: “Individually, we may be strong, but collectively, we are stronger.”

“When we work together, we can have a louder voice, a wider reach, and a unified message…” she continues. “When we work together, we can pool our resources to do bigger programming. When we work together, we can see what services already exist and instead of replicating something that another organization is doing, we can find the gaps in services and fill them. Similarly, we can see what populations other organizations are serving and find gaps so that they entire community can be reached.”

Redhead Design Studio’s Principal, Creative Director Jennifer Estill says she and her team were excited to collaborate on the Get Real About Breastfeeding campaign because they love to engage in purposeful and meaningful work. Estill, a breastfeeding mother herself, reflects on her experience nursing her children: “[Breastfeeding] is one of those things in life you don’t have any clue what you’re getting into. It’s harder and more rewarding than you ever think it’s going to be.”

But a lot of the infant feeding imagery moms and the public are fed today doesn’t reflect the realities of parenthood.

“A lot of the imagery is almost mythical,” Estill comments.  

So, during the photoshoot for the campaign, the nine breastfeeding families weren’t told what to wear, how much skin to show or how to hold their baby.

“[The pictures] turned out to be really real and true,” Estill says.  

Greiter adds that breastfeeding looks different for different moms.

“Every drop counts and every mom and baby have their own breastfeeding journey,” she says.

When the team designed this campaign, Greiter reports that they thought long and hard about what message they would convey. The health benefits of breastfeeding are well-known, so they avoided this messaging. Instead, the message they hope to get across is twofold.

“First moms, get real about breastfeeding,” Greiter says. “Breastfeeding is tough, but you’re tougher.”

The second part is for the public.

“Babies have to eat, and we want moms to breastfeed, so get used to it,” Greiter continues.

Seeing the breastfeeding images around town has been an empowering experience for those involved.

“It makes our moms feel proud that they are breastfeeding their babies, and it helps other moms see that people just like them are doing it, and they can do it too,” Greiter says.

In the following Q&A, Ingham County Health Department’s Healthy Start Supervisor Isa Solís, MSW and Health Officer Linda S. Vail, MPA share more about the Get Real About Breastfeeding campaign and the community it serves.

Q: What was the inspiration for this campaign?

A: According to the most recently published Michigan Pregnancy Risk Assessment Monitoring System (PRAMS) breastfeeding data, Michigan as a whole continues to fall below the US Healthy People goals for breastfeeding in both breastfeeding initiation (73.4% vs. goal of 75%) and exclusive breastfeeding at 3 months (31% vs. goal of 60%).  However, some groups in Michigan are doing better with breastfeeding than others, and the disparities in these rates across age, race and education levels are striking.  Non-Hispanic African American mothers are significantly less likely to initiate breastfeeding (54.9%) than non-Hispanic white mothers (72.1%). Non-Hispanic African American mothers are also much less likely to exclusively breastfeed at 3 months (19.2%) compared to non-Hispanic white mothers (34.2%).  Similar differences in these breastfeeding rates can be seen between younger and older mothers, and between mothers with a high school education or less and those with higher education levels.

Get Real About Breastfeeding celebrates mothers who breastfeed, acknowledging that breastfeeding is often not easy, reminding people that breastfeeding in public is legal, healthy, and normal, and encouraging others to provide support to breastfeeding moms and families.  The campaign also seeks to combat misinformation and hurdles, encourage moms to start breastfeeding and continue breastfeeding, and normalize breastfeeding in our culture.

To connect with local pregnant and nursing moms in an authentic manner, the campaign shares personal stories from local moms, featured in the campaign, around topics such as The First Six Weeks, The Hardest Part, Pumping and Bottle Feeding, Health Benefits, Making the Commitment, Nursing in Public, Partner Support, and Getting Help.

Q: Tell us about the community you serve.

A: As a local health department, the Ingham County Health Department (ICHD) is charged with protecting the health and welfare of county residents. The Department has an annual operating budget of approximately $40 million and over 375 employees. The Department is organized into three overarching divisions: Public Health Services, where traditional and contemporary public health activities are located; Community Health Center Services, which houses Federally Qualified Health Centers; and the Bureau of Environmental Health, which oversees regulatory environmental health function.

The Health Department’s primary offices, located in south Lansing, provide traditional public and population health services including immunizations, WIC, communicable disease control, public health nursing, and environmental health services. This location is also home to four Community Health Centers (CHCs): Adult Health, Adult Dental, Child Health, and Women’s Health. The CHCs incorporate a patient-centered medical home model, utilizing social workers, nutritionists, nurse practitioners, physician assistants and physicians to provide comprehensive and coordinated primary care services to low income residents. The Department also provides services through nine other locations throughout the community, providing access and community presence in areas with the most vulnerable members of the population.

The Maternal and Child Health (MCH) Division provides community nursing, nutrition education and social work services in homes, schools and other community settings.  These services are largely directed at preventing health problems in high-risk populations.  Assessment, coordination of care, health education, and referral to appropriate community resources are key components of the services.  

There are an estimated 69,079 women of childbearing age in Ingham County. The largest proportion of women of childbearing age is between 35-49 years old (37.7%) followed by women 20-24 years (33.1%). Mirroring the general population, the largest proportion of women in this group are non-Hispanic White (74.2%), followed by non-Hispanic Black/African American (11.1%), Hispanic, any race (6.4%), and Asians (5.3%)4. Although sample sizes for American Indian /Alaskan Native and Native Hawaiian /Pacific Islander were not large enough to report, community partners will still be engaged to disseminate information about the HS Project to all communities of color.

According to the American Community Survey, the primary language for most women of childbearing age in Ingham County is English. However, one in ten women are more comfortable speaking Spanish, or another language. Most of the women of childbearing age (41.5%) have never been married, but they are closely followed by the proportion of married women in the population (37.2%). One in five women in Ingham County are formerly married (separated, divorced, or widowed).

The majority of women of childbearing age in Ingham County are employed. One third of women are not employed and are not seeking employment. The median income for women is lower than that of the general population ($37,056 compared to $47,211). Close to a quarter of women in Ingham County live in households below the federal poverty level.

Q: What breastfeeding support programs are you most proud of?

A: ICHD is proud to offer extensive breastfeeding support to moms and the community via our Women, Infants, and Children (WIC) and home visiting programs.  Below, are a few of the services and programs that ICHD offers related to breastfeeding:

  • The WIC program is a federal food and nutrition program that acts as an adjunct to prenatal and pediatric health care. The goal of WIC is to eliminate nutritional deficiency as a contributing factor in neonatal death, low birth weight, and other significant health problems of children and pregnant or breastfeeding mothers. Eligible women and children receive breastfeeding support, nutrition counseling and education, and nutritious foods to supplement and improve their diet. These foods may include milk, whole grains, cheese, eggs, juice, peanut butter, dry beans and peas, and infant formula if necessary.
    • WIC also offers Baby Café, which is a free, drop-in Breastfeeding Center. It’s an informal, comfortable place for breastfeeding moms or moms who are thinking about breastfeeding. Moms can receive breastfeeding support and information. Breast pumps are available for loan.
  • Strong Start | Healthy Start is an initiative of the Ingham County Health Department to enhance the health of African-American families and improve birth outcomes in Ingham County.  Through family support, parent coaching, education, breastfeeding support, and case management, Healthy Start works to promote health and decrease infant deaths in our community.  
    • Healthy Start, in collaboration with Willow Tree Family Center, also offers a mother-led breastfeeding support group, Black Breastfeeding Sisterhood, held twice a month. Mothers are able to share their experiences and learn from other mothers in a welcoming and supportive community setting. Pregnant and breastfeeding mothers enjoy fellowship, sisterhood and breastfeeding support. Additionally, mothers are able to meet with Breastfeeding Peer Counselors to get advice on breastfeeding concerns and to discuss topics such as milk storage, social barriers, and incorporating breastfeeding into your lifestyle.
  • The Maternal Infant Health Program (MIHP) is the largest home visiting program in Michigan serving pregnant women and infants up to the age of one receiving Medicaid in Ingham County. Services are a covered benefit of Medicaid and the managed health plans.  MIHP provides support to promote healthy pregnancies, good birth outcomes, and healthy infants. MIHP families receive services by a team of nurses, social workers, breastfeeding counselors and dietitians to connect families with the information and support needed to have a healthy pregnancy and baby.
  • Nurse-Family Partnership is a program for women who are having their first baby. Once enrolled, a registered nurse will visit families in their home throughout pregnancy and continue to visit until the baby is 2 years old.  A nurse will help families have a healthy pregnancy and a healthy baby, become a better parent, build a strong network of support for mom and the baby, make the home a safe place for the  baby to live and play.

Q: Please tell us about the importance of networking and collaboration as it pertains to supporting families’ infant feeding goals.

A: Collaboration enables us to accomplish jointly something that one agency alone could not. Many funding agencies and agencies that seek to make a profound impact in their communities have recognized the power that collaboration can bring and are now calling for interagency collaboration as part of the criteria for grantee selection. As a local health department promoting the idea that breastfeeding is legal, healthy, and normal, we knew that it was important to engage other stakeholders to ensure that a common goal was shared among other institutional partners that offer similar services and have similar goals in mind.

Q: What challenges were associated with this campaign?

A: Too often we expect self-sacrifice from individuals and organizations as they move toward coalition solutions. If we understand that people and organizations may be motivated by self-interest, then we can approach a situation by looking for strategies to lessen territoriality and consider self-interest. It is also possible to minimize the effect of territoriality and self-interest by appealing to a larger good.

With the Get Real About Breastfeeding Campaign, we understood that the multitude of agencies represented- 20 in the Capital Area Breastfeeding Coalition alone- had specific self-interests.  As the agency funding this initiative, we wanted to make sure that we were good stewards of federal dollars and meeting the grant requirements, while still engaging and motivating partners to utilize their ideas and innovative approaches to breastfeeding promotion to have a common core message.

The other challenge presented was making sure that we agreed on utilizing local moms to be represented in the campaign.  We wanted to highlight the stories or real and local breastfeeding mothers without telling the story for them or speaking for them.  We were very cautious to seek their input and ensure that they requests of the group and the slogans associated with each were truly reflective in how they saw their breastfeeding journey.  

Q: Future plans for the campaign?

A: Future plans include continuing to share our story so that other local, state, and national partners can hopefully replicate Ingham County’s efforts to give breastfeeding moms a voice and to affirm that breastfeeding is legal, healthy, and normal.  We also hope to expand the traveling gallery initiative to include non-public health or health-focused organizations and engage the economic development and business sectors in discussions to support nursing moms and promote breastfeeding. Additionally, we hope to embed videos, of moms depicted in the campaign, so that there is an additional method to engage community members aside from stories written via written text.  Lastly, we are in discussions about a local event, during breastfeeding awareness month, where we bring moms back for a celebration to share their stories with other community members, stakeholders, and policy-makers to continue to promote the message that breastfeeding is legal, healthy, and normal.

Q: How has the community responded to the campaign thus far? Have you been surprised by the responses?

A: The responses from the community have been overwhelmingly positive. We have seen social media explode with positive remarks once the campaign images were initially shared by Redhead Design Studio.  Mothers and supporters are feeling validated that nursing is normal and healthy and have also found a platform, and voice, to share their stories of being previously humiliated for nursing in public.  They are additionally validated because the mothers featured the campaign are local nursing mothers.  There is a genuine connection to the campaign because of those relational links that affirm the bond, not only among women from the same community, but also among nursing mothers.

From an interagency and institutional perspective, the campaign has been lauded by the Michigan Department of Health and Human Services.  They are looking at mechanism to replicate this campaign, and also use local moms and voices, to promote breastfeeding.  The campaign has additionally received praise from local and state media and has been featured in several news segments over the last couple of weeks.  The stories first focused on the visibility of the campaigns throughout the community to now being labeled as a nationwide campaign to end the stigma and discrimination that nursing mother’s experience. Additionally, we have received requests from as close as Southeast Michigan to as far as Germany to utilize the images and information about the campaign in periodicals and other scholarly sources.

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