Fostering Community Support for Breastfeeding: Implementation of a Neighborhood Level Breastfeeding Initiative in Brooklyn, New York.

To share lessons learned from the New York City Department of Health and Mental Hygiene's Brooklyn Breastfeeding Empowerment Zone initiative to increase breastfeeding duration rates in the Brooklyn Community Districts (CDs) of Bedford-Stuyvesant and Brownsville, and to evaluate the degree to which the initiative mobilized community support, and impacted breastfeeding. These neighborhoods were chosen due to historically low breastfeeding rates. Highly frequented community establishments such as restaurants/cafés, beauty salons, pharmacies and retail shops were selected as potential breastfeeding friendly spaces (BFSs) to support and welcome breastfeeding mothers. Staff visited each establishment to explain project objectives and requirements and inquired about interest in becoming a BFS. A Baby Café was also established in Brownsville to offer practical breastfeeding advice for mothers. Of the 178 potential BFSs identified in both CDs, 123 (69%) agreed to become BFSs. The Brownsville Baby Café, established in 2018, surpassed its goal of hosting 26 sessions in the first year. Class feedback surveys indicated that the primary reason for attending was to learn more about breastfeeding and other information to support their babies (52%), and 84% were satisfied with or confident about the responses they received. Between 2009 and 2012 to 2017-2020, there were statistically significant increases in breastfeeding initiation (83.9-95.7%) (P < 0.05), and exclusivity (9.7-29.9%) (p < 0.05) in Brownsville. The BFEZ initiative successfully engaged community establishments, formed a support group to help breastfeeding families, and showed how these initiatives can help to change the social environment and outcomes related to breastfeeding.