According to the 2022 Breastfeeding Report Card, 83.6 % of babies born in Delaware in 2019 were “ever breastfed or fed breast milk” ; equal to the national estimate of 83.2%.  Within this measure, there are disparities by both race/ethnicity and household income level.  As is the case nationally, rates of breastfeeding initiation are lowest for Black, non-Hispanic infants, as well as infants in low-income households. These disparities are mirrored in the data for longer-term breastfeeding, with the overall rate dropping to just 25% of infants who are breastfed exclusively for 6 months; equal to the national average of 24.9%.

According to Pregnancy Risk Assessment and Monitoring System (PRAMS) 2012-2021 data, the percentage of women who ever breastfed increased by 12% from 79.2% in 2012 to 88.6% in 2021 and currently breastfeeding (i.e., at the time of survey) increased by 23% from 48.8% in 2012 to 60.1% in 2021 among women with a recent live birth. There were differences in breastfeeding rates by race and ethnicity. For instance, based on PRAMS data, the 2021 prevalence of ever breastfed among Black non-Hispanics was 85.0% as compared to 88.0% among White non-Hispanics, 91.4% among Hispanics, and 96.7% among other races non-Hispanic. Similarly, the 2021 prevalence of currently breastfeeding (or at the time of survey) among Black non-Hispanics was 48.1% as compared with 64.4% among White non-Hispanics and 57.7% % among Hispanics, and 71.9% among other races non-Hispanic.

This data shows the need for improvements in overall breastfeeding initiation but also improvement in the disparities that exist in Delaware. In addition, the input gathered through our needs assessment process showed overwhelming support from partners to address this area.  Through a survey of MCH stakeholders, breastfeeding was ranked as the number one national performance measure for our Title V program to address in the perinatal/infant domain, and 72% indicated that there was a strong desire among stakeholders to address the issue.

The following activities have been accomplished this past year with the use of Title V funding and through partnerships with entities such as the DHMIC, WIC and the Breastfeeding Coalition of Delaware (BCD).

The DE WIC program is pleased to share the findings of the most recent participant survey launched this Spring.  The survey revealed a 97% Satisfaction Rate with WIC services, based on willingness to refer the WIC program to a friend or colleague. 

The survey was successfully sent out via the WIC program’s texting service used to communicate events, helpful suggestions, and appointment reminders.  Of the 220 Participants who answered the survey, 85% found the texting service was useful with others giving suggestions to further refine the program’s messages and timing.  When asked about their experiences with WIC clinics, 87% were happy with the quality of services, 82% were satisfied or very satisfied with WIC staff, and 81% found appointments were easy to schedule. 

Participants shared that the majority of those responding had talked with a Breastfeeding Peer Counselor and 96% felt the experience was good to excellent.  Participants sought help from peer counselors on topics such as breastfeeding goals, latching techniques, pumping, and emotional support.  All findings will help inform future improvement efforts while also providing an opportunity to thank staff for the great results!

According to the Gibbious findings in the First and Second Quarter Report of Fiscal year 2023 and the WIC WOW Data System:

• Breastfeeding initiation at increased by 4% in the last two quarters

• Breastfeeding Initiation rates in the WIC population has increased by 2% from the 1st to the 2nd quarter
• Exclusivity increased by 3% from the 1st to the 2nd quarter
• 12-month Duration remained level during the 1st and 2nd quarter

WIC programs offer peer counselors.  “Peer” means that the counselor has breastfeed their own baby and can help other mothers breastfeed.  According to Gibbious findings of the May FY 2023 second quarter, a participant contacted by a peer counselor is 95% more likely to be breastfeeding at 3 months and 81% more likely to be breastfeeding at 6 months.

The Delaware WIC Program will again be hosting the Annual Breastfeeding Event virtually on August 3, 2023.  The guest speaker is Laurel Wilson of Mother journey.  Her topics of discussion include:

• “Addressing Sore Nipples and Painful Mammary Tissue”,
• “The Potential Impact of Perinatal Cannabis”,
• “Gut Reaction” and “The Milk Sharing Conundrum”

Delaware WIC offices are scheduled to reopen on August 9, 2023, with a modified schedule pending FNS approval. The virtual breastfeeding classes remain successful and will continue to be offered. Currently, classes are offered the first and third Wednesday of each month at 11am and 5pm.  However, a third breastfeeding class was added on the third Saturday of each month starting at 11am.  

The Community Breastfeeding Partnerships with the Delaware WIC Program, Christiana Health Care Systems, The Latin American Community Center, Nemours Pediatrics, Westside Family Health, The Breastfeeding Coalition of Delaware, The Perdue Chicken Plants of Milford and Georgetown and The Delaware Healthy Mother and Infant Consortium continue to be robust and are thriving.

One clear need in our state is to enhance the supports that are available to women in the early days and months after birth, when breastfeeding is being initiated and becoming a routine. Over the past several years DPH has worked on expanding state breastfeeding capacity - promoting the transformation of Delaware hospitals into Baby Friendly hospitals and improving access to professional and peer support for breastfeeding in the community. Four out the six birth facilities in the state have received baby friendly designation including our largest birthing hospital. The other two birthing facilities are interested, however little progress has been made.  One of the birthing facilities, Nanticoke was bought by Tidal Health and being designated a Baby Friendly facility was not a pressing priority.  In the most recent CDC Maternity Practices in Infant Nutrition & Care, Delaware scored an 84 which slighting higher than the national average of 81.  The BCD continues to provide support to birthing facilities to maintain certification.

DE WIC built a cross-functional team that includes WIC program staff, local clinic staff, birthing hospital leadership, and community peer counselors to meet quarterly to review the latest breastfeeding rates and develop big and small strategies to enhance the peer counselor role and breastfeeding supports across the state. In coordination with the team, the WIC program does an annual survey of participants to identify issues and inform participant-driven strategies. Some initiatives that the Delaware program has successfully implemented include a major push to inform moms of their breastfeeding rights, increased breastfeeding awareness by state employees in co-located facilities and integrating the peer counselors into the WIC clinics to support groups and foster one-on-one interactions.  The team has recently begun looking at service patterns and seeing where targeted intervention can improve supports. The WIC team is also exploring the use of telehealth with our WIC Breastfeeding Peer Counselors in providing virtual breastfeeding classes to our WIC moms.

The observance of Black breastfeeding Week Aug 25 – 31st 2022 is particularly important to address since black babies in Delaware “are almost 3 times more likely to die than white babies before their first birthday. Delawareans could help reduce infant mortality by eliminating disparities in breastfeeding.  DEThrives created a blog post titled “Black Breastfeeding Week 2022”, which also ranked as the number one searched for blog post during this quarter (July – September 2022), that listed free community events to help promote Black Breastfeeding Week partner events. These local events ranged from a community doula program, a community “Group Latch” about breastfeeding, a “Painting with a Twist” opportunity to paint a breastfeeding inspired canvas, a coffeehouse style book reading of “Free to Breastfeed: Voices of Black Mothers”, an online Zoom celebration titled “The Big LATCH!”, and a documentary titled “Aftershock” which showcased the discussion of the black maternal health crisis followed by a panel discussion of women’s health and reproductive rights led by Delaware State Representative Melissa Minor Brown and other community partners. A Save the Date Flyer was also produced to help spread the awareness of the observance and the community events. Interviews on the topic occurred along with an e-blast email that was sent out to increase awareness of this observance and to increase awareness of the importance and benefits of breastfeeding, particularly in the black and brown population, for mothers and their families.  Between August 18th – August 25th, 2022, a single image newsfeed ad was published recognizing Black Breastfeeding Week. Once the ad was clicked, it redirected the user to the “Black Breastfeeding Week 2022” blog post which shared a list of community events and resources celebrating this observance.  The objective of the ad was to drive traffic to the “Black Breastfeeding Week 2022’s” blog post on the DEThrives site. The ad reached over 16K users, had over 62K impressions, 76 clicks, and a 3.8 frequency. This ad also earned the most social engagement this quarter, specifically on DEThrives’ Facebook and Twitter platforms, with 109 overall (the term “overall” is defined as adding up the analytic #s found on all 3 platforms of FB, IG, and TW) post reactions.