(P18-031-23) The Mama Sana Program: Program Evaluation, Patient Experiences and Future Directions

Objectives: The Mama Sana program at Brigham and Women’s Hospital was developed to address disparities in breastfeeding rates among Hispanic birthing parents with Spanish Language Preference (HBP-SLP). A bilingual certified lactation counselor (CLC) provided lactation support to HBP-SLP during the delivery hospitalization, with virtual postpartum (pp) follow-up. The objective of this study was to evaluate outcomes of the Mama Sana program and assess patient experience.

Methods: We defined 2 epochs: pre- (Epoch 1: 8/21-12/21, n=88) and during Mama Sana (Epoch 2: 1/22-1/23, n=231). Outcomes were any breastfeeding (BF) at discharge (primary), 6 weeks pp (secondary) and receipt of language-concordant CLC support (process measure). Data was collected from the medical record and compared between epochs using chi-squared tests. To further understand needs, we conducted a survey and interviews in a subset of Mama Sana participants. For qualitative data, transcripts were double-coded and themes identified using NVivo.

Results: 94% of HBP-SLP provided breastmilk (BM) during hospitalization after Mama Sana (epoch 2) vs. 90% before Mama Sana (epoch 1) (p=0.26). At six weeks pp, 36% were exclusively BF their infant in epoch 2 vs. 31% in epoch 1 (p=0.44). In epoch 2, 74% of HBP-SLP received CLC support in Spanish vs. 6% in epoch 1 (p < 0.0001). From surveys (n=36), 92% of mothers reported a desire to provide some BM to their infants, but only 73% reported feeling “very confident” or “confident” in their knowledge & skills to feed their baby. In interviews (n=9), Mama Sana patients described valuing in-person, language concordant, hands-on CLC support in the hospital and would additionally benefit from: i) classes during pregnancy & post-discharge, held virtually to minimize barriers (e.g. transportation, child care); ii) integrated nutrition & CLC support; iii) group classes to build peer relationships; iii) support for return to work while BF; iv) tools to navigate contradictory BF messaging (e.g. family vs. providers).

Conclusions: An in-hospital language and culturally concordant lactation program increased the proportion of HBP-SLP who received lactation support in their native language. Integrating patient perspective into program expansion is critical to further impact outcomes. 

Funding Sources: BWH Department of Pediatric of Newborn Medicine, Pechter Family Foundation