A comprehensive education strategy is presented that links training, community education, research, and mass-media efforts to enhance breastfeeding practices. Breastfeeding promotion models, an administrative system, and lessons learned during the project are described. The keys to effective breastfeeding promotion are shown to be accurate information; appropriate education, training, and follow-up; and a supportive administrative system.
PIP: An operations research project designed to determine what model of intervention was most successful in promoting breast feeding among 585 urban women in Mexico began in 1986. The interventions involved having trained promoters teach and counsel breast feeding mothers in Irapuato, program supervisors teach groups of mothers in Chihuahua, and both trained promoters and program supervisors train individuals or groups in Cuauhtemoc. Jalapa served as the control site. The breast feeding prevalence rate in the 4 communities varied from 64.5%-81.3% prior to intervention with a mean in the target group of 74.9%. The mean climbed to 88.8% for this group after intervention. Further, the breast feeding prevalence rate for Jalapa fell from 65.9%-56%. In addition, 70% of the women in the experimental group exclusively breast fed their infants during the 1st month whereas only 63.3% in the control did. Subsequent months' breast feeding prevalence rates decreased o 13.7% and 14.7% (5 months) and 9.4% and 3.3% (6 months) in the experimental and control groups respectively. Informal support groups of breast feeding mothers formed unexpectedly as a result of the educational and outreach activities. The data showed that the intervention model using the promoters was the most successful strategy. They also provided the researchers and other health care professionals interested in promoting community based breast feeding programs with guidelines. For example, supervisors should not discourage promoters from addressing other community needs since discouraging them can jeopardize their dedication to breast feeding promotion. Further, program planners should gather geographic and sociodemographic data of the area and population prior to planning and intervention.