Social - Ecological Model:
Promoting breastfeeding at many levels

As outlined in the Six Steps to Building Local Breastfeeding Coalitions, one of the first steps of coalition building is making a list of who influences a mother's breastfeeding success.  Influencers include parents, partners, mothers or in-laws, physicians, child care providers, churches, employers, legislators and the media.

You, as the individual breastfeeding advocate or coalition of advocates can influence these influencers.

To understand some of the means of doing this, review the following chart. It was drafted in 2004 by the Portland Area Breastfeeding Coalition, as inspired by the article Breastfeeding among Low-income, African-American Women: Power, Beliefs and Decision Making.

 

Social Ecological Framework and corresponding breastfeeding promotion activities


INDIVIDUAL: the breastfeeding mother, within her culture

  • Learn about cultural-specific frameworks, barriers and needs.


INTERPERSONAL: in direct contact, such as family, friends, social networks, health care providers

  • One-on-one visits or phone calls.
  • Education to health care providers.
  • Education to family members of breastfeeding mother.
  • Increase and diversify trained peer counselor base across the city those formally counseling and those who find their own models.


COMMUNITY/ENVIRONMENT: neighborhood, community, workplace, hospital

  • World Breastfeeding Week Activity.
  • Local Proclamations (e.g. OR Governor declared August BF Promotion month).
  • Hold nurse-ins to respond to specific infringements on a mothers right to nurse in public.
  • Put on a skit humorously dramatizing a breastfeeding issue or law.
  • Identify community organizations serving populations unlikely to nurse. Provide education and information to staff and program participants.
  • Give health education talks in the schools to staff and students. Ask breastfeeding to be included in human reproduction curriculum.
  • Distribute Breastfeeding Welcome Here stickers from Oregon DHS.
  • Promote the Oregon Breastfeeding Mother Friendly Employer Project.
  • Request the library purchase books with positive breastfeeding images.
  • Host conferences to health care providers with continuing education credit available.

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ORGANIZATIONAL: AAP, AABA, LLL, Formula industry, ACOG, etc.

  • Advocacy.
  • Letter writing.
  • Build coalitions to strengthen the above.
  • Lobby the formula industry let them know intelligent people are paying attention.
  • Influence hospital policy push for Baby-Friendly.
  • Establish a Medical Association within the statewide coaltiion. Attract physician enrollment, making criteria and rewards that make it attractive to physicians and beneficial to breastfeeding policy.
  • Evaluate programs in community, identify gaps and fill them.


POLICY: welfare reform, WIC, WHO Code, Breastfeeding legislation, family and medical leave act

  • Workplace accommodation legislation.
  • Appeal Oregon Health Plan for increased coverage of LC visits and pump rentals.
  • Evaluate WICs breastfeeding services, then fill in gaps such as pump distribution or weekend breastfeeding assistance.
  • Accept the rising prevalence of breastmilk biomonitoring for information on toxins in the environment. Team with environmental groups or others participating in this work, and influence the message to protect breastfeeding as much as possible.

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MEDIA:

  • Promote the National Breastfeeding Awareness Campaign.
  • Create press releases of new studies, keep breastfeeding in the news.
  • Identify specific reporters at news outlets, find the advocates.
  • Invite a reporter or prominent Communications Director to be part of the Coalition.