We are so proud of the community we have through Women’s Birth and Wellness Center! We recently completed a survey of some of you to see how our community was doing with breastfeeding over the long term. Thank you to all the families who participated in the survey, and our apologies to those who might have gotten the survey in error. It was our first breastfeeding survey, and we learned some extra steps we will use when doing future surveys. We knew there was a lot of breastfeeding going on, but this survey helped us understand just how much there was!
     The results we got were astounding! We knew that our community was special, but this survey quantifies one aspect of what makes it so remarkable.
     We emailed our survey to 416 WBWC families who had babies between 6 months and 18 months of age to ask a short series of questions about their breastfeeding experience. Out of the email surveys we sent, 215 were completed, which was about a 52% response rate. Most of our respondents (95%) intended to exclusively breastfeed for the first six months of their babies’ lives; 28% of those intended to nurse just at the breast, while 72% planned to mix breast feeding at the breast and using pumped breast milk. Five percent of our mothers were planning on breast milk and formula feeding in the first 6 months. No one planned to formula feed exclusively.
     Sometimes, despite the best of intentions, women who plan to breastfeed are not able to continue to breastfeed because of problems, or lack of support. For instance, in one group of about 900 women, when asked prenatally (different from our survey, which asked women to remember what their intentions were), about 75% of the original group of women wanted to exclusively breastfeed. By the end of the first month, 15% of them were still exclusively breastfeeding; the rest had introduced formula or were fully formula feeding. While women who choose to give birth in an out of hospital birth center are different from the general population in many ways, this is one example of what things might look like in other settings.
     In our community, almost everyone who responded to the survey wanted to exclusively breastfeed for the first 6 months. At six months, almost everyone had met their goals. At 3 months, 91.5% were still exclusively breastfeeding; 97% were still breastfeeding but also using some formula. At six months, 85% of women were still exclusively breastfeeding and another 10% were breastfeeding and also using some formula. This means that at 6 months, while some women who hoped to be exclusively breastfeeding were not, we still had a 95% breastfeeding rate. See how different this is?


     Here’s another way to look at it. Let’s compare our rates of exclusive breastfeeding to rates in the United States and North Carolina. 1 Overall, North Carolina and the United States have better rates of ‘any breastfeeding’ than exclusive breastfeeding. In this category, we have over twice as many women breastfeeding as in the United States, and not quite three times as many women breastfeeding as in our own state. When you look at exclusive breastfeeding, by six months, we are about eight times above the average for North Carolina, and over four times the average for the United States. Pretty good!





Why Are Our Rates So High?
     We don’t know exactly what makes our breastfeeding rates so high, but there are some things that we have built into our care that certainly help. There is a lot of research about how important support is for breastfeeding mothers.  That includes support from other mothers and from health care providers both prenatally and after the baby is born. In our community, most women who responded to the survey (80%) answered that they had received some kind of support. Most of that support was from a lactation consultant (73%), followed by a breastfeeding class (43%), and La Leche League (27%). Some women may have responded ‘yes’ in more than one of these categories. Another is giving birth in a Baby Friendly2 facility. Our birth center received Baby Friendly status in 2010 and UNC Hospitals received Baby Friendly status this year. Twenty-nine percent of our respondents gave birth at UNC, and 71% gave birth at WBWC. While UNC wasn’t Baby Friendly at the time that our survey respondents would have given birth there, it was working toward that status, and many of the recommended practices would already have been in place.  Additionally, we know that all of us at Women’s Birth and Wellness Center love breastfeeding, and are knowledgeable and supportive of our mamas when they need help. Whether the birth took place at the WBWC or at the hospital, that love and support was there.
     So there are many things that make breastfeeding at Women’s Birth and Wellness Center work. One is the commitment of the women who choose our center as a place to give birth and the support those women seek on their own. But we also hope that our care is a part of the picture. Most of our survey respondents saw a lactation consultant. Although we don’t know whether that was through the WBWC or through the hospital or community LCs, we hope that many took advantage of MILC (Mother’s and Infant’s Lactation Care), the breastfeeding support network of classes, full clinic hours available for visits with an International Board Certified Lactation Consultant (IBCLC), and support programs that we offer at WBWC.
Thank You
     So thank you again to our community. We appreciate the time you took to communicate with us. Breastfeeding, while it is often natural and normal and completely carefree, can also sometimes be difficult. As lactation consultants, we stand witness to how very hard women sometimes work to achieve their breastfeeding goals. We see families push themselves to the outer edges of their ability to cope in order to maintain breastfeeding as much as possible. It is an honor and a gift to stand with families and witness their bravery and commitment. This is what we see when we, as lactation consultants, see this many women exclusively breastfeeding at 6 months. We see this, and a fabulous community of wonderful families brought together in a setting in which we are proud to participate.
Ellen Chetwynd
Nancy Albrecht
Elley Schopler
WBWC Lactation Consultants
Thank you to the volunteers who worked on this project: Kathy Parry, Meribeth Harlow, and Katie Mills.



1. http://www.cdc.gov/breastfeeding/data/NIS_data/, 2007 data
2. http://www.babyfriendlyusa.org/eng/index.html