>
>
>Best Start has a similar approach where you so to the woman, "Tell me what
>you've heard about breastfeeding."  That way she will open up in the manner
>that you described, and you will have an opportunity to give her targeted
>information on the issues that she brings up.
>
With a high-risk group (on-reserve, very low initiation rates)
population I used a two-part approach that has worked well with another
high-risk group (teen moms). First, you ask what good things they've
heard about breastfeeding. Second, you ask why some women would choose
not to breastfeed in spite of these reasons. You say, "some women"
rather than "you" so that they can distance themselves from these
opinions. Asking why "you" might not breastfeed could reinforce the
decision (they would start thinking of reasons, whether or not based on
facts, evidence, etc.)

I want to point out that this is different from the "breastfeeding is
normal" approach that can be used in the general population, that is,
framing the question (such as "What questions do you have about bf?")
because I felt it was important to acknowledge the  "I didn't / wouldn't
do it because..." stories of their mothers, sisters and friends carried
by the women.

There is also merit in building on the positive -- beginning by talking
about what is good, healthy, loving, etc. It's an extremely effective
"world-changer."

Jo-Anne Elder-Gomes, PhD, IBCLC

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