“Every hour of every day, almost 500 new mothers across the United States face the same decision: How to feed their newborns. There is unanimity in science that breast milk is the best source of infant nutrition. Hence, the federal government’s Healthy People 2020 set goals of 81.9% initiation of breastfeeding and 60.5% continuation at six months."

Breast for Success has been developed to be culturally appropriate and engages both staff and participant in a manner that both respects the “real-life” issues of these new mothers and provides them and their support community with the necessary tools to succeed. Breast for Success has also received support from the American Academy of Pediatrics (AAP) through two CATCH (Community Access to Child Health) grants.

Early infant nutrition is one of the most powerful factors that determine early growth and development. From a reduced risk of obesity to an increased resistance to disease, evidence about the health advantages of breastfeeding for both mother and child continues to grow. Breast milk itself and the way the baby feeds help the child develop healthy eating patterns. Breastfed babies seem to be able to regulate more effectively their food intake and thus are at lower risk of obesity. Breast milk may be the first example in our evolutionary history of “personalized medicine.”

Many health professional organizations (including the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American Public Health Association, among others) officially recommend that most infants breastfeed for at least 12 months, based on the recognized important benefits of breastfeeding for the health of both mother and child. These organizations also recommend that infants be exclusively breastfed for about the first six months. These organizations also acknowledge that within high-risk, inner-city populations, a significant determinant of both intent to breastfeed and initiation of breastfeeding includes support from the baby’s father.

In 2011, in direct response to an understanding of the short-term and long-term value to both mother and child, The Mt. Sinai Health Care Foundation provided funding for Breast for Success: A Family-Centered Intervention in Support of Breastfeeding among High-Risk, Low-Income Mothers in Cleveland, an educational, home-based intervention that encourages and nurtures the engagement of the mother, her partner, and her support network. The program, under the direction of Lydia Furman, MD, a pediatrician at University Hospitals Rainbow Babies & Children’s Hospital, involves two well-established and well-regarded community partners – Cleveland Department of Public Health’s MomsFirst™ program, an outreach program for pregnant mothers who live in the City of Cleveland, and the Healthy Fathering Collaborative of Greater Cleveland, a network of public and private agencies dedicated to supporting fathers, families and children in Greater Cleveland, sponsored by The Community Endeavors Foundation. The goal of Breast for Success is to provide better education and support that will help overcome barriers associated with breastfeeding, thus increasing the rates of initiation, continuation, and exclusivity of breastfeeding within this identified population (low-income, inner-city, mainly African American women).

Aligning with its successful Healthy Start model, Cleveland Department of Public Health’s MomsFirst™, the primary partner for this project, delivers comprehensive services including twice-monthly community health worker home visits prenatally through two years postpartum. A dedicated certified lactation counselor serves as a resource to the staff and provides direct service to the mothers. Three key components help to support the participants. An enhanced breastfeeding curriculum includes games, DVDs, other supportive materials and interactive activities. The identification of a breastfeeding doula for the mothers provides the opportunity to broaden the impact of the educational component. The Father Support Program is based on the knowledge that support of the father, regardless of socioeconomic status, is the best predictor of successful initiation and continuation of breastfeeding by the mother. This component is designed to educate the fathers both on the importance of breastfeeding and to dispel the myths concerning breastfeeding.

With Healthy People 2020 setting targets for initiation and continuation of breastfeeding, Breast for Success is doing its part by identifying short-term goals of increased breastfeeding rates among MomsFirst mothers and the long-term goal of creation of a replicable model program that reduces health disparities and improves health of high-risk, inner-city families by increasing breastfeeding rates.