Breastfeeding-friendly shelters initiative faces challenges

Federal and local policy changes impacted programming in shelters in 2018.

The city of Philadelphia Office of Homeless Services (OHS) has adopted a Housing First model, an approach that prioritizes permanent housing as the goal for families experiencing homelessness and places less emphasis on other supportive services during shelter stays.

Shelter staff are trying to figure out how to make Housing First fit at their sites. In an effort to reduce barriers to housing, many shelters have removed program requirements and have shifted staff responsibilities. This has made it challenging for Homeless Health Initiative (HHI) to expand its programming that encourages and facilitates breastfeeding in shelters.

HHI is working tirelessly to gain OHS and shelter staff support to create a cultural norm of breastfeeding in shelters. Despite the challenges, HHI was able to host three Breastfeeding-friendly Shelters Committee meetings in 2018, and continued to support pregnant and breastfeeding mothers on their breastfeeding journeys by connecting them to lactation consultants.

By the end of 2018, HHI was working with potential donors to have hospital-grade pumps and pump kits donated to three family shelters. Hospital-grade pumps are much faster than personal pumps, making it easier for working mothers to continue breastfeeding for the recommended first six months to one year.

One of the Breastfeeding-friendly Shelters Committee partners, Health Promotion Council/Public Health Management Corp., completed its study exploring the attitudes and experiences of mothers and shelter staff regarding breastfeeding in Philadelphia area shelters. Although the report is not yet ready for dissemination, it will provide evidence to support HHI’s Breastfeeding-friendly Shelters Initiative.

HHI plans to use this information, along with recently published research showing that infants are more likely than any other age group of children to live in shelters, to advocate for breastfeeding as a way to mitigate the detrimental effects of living in shelter on infant development.

LEND fellows focus on breastfeeding-friendly shelter initiative and SPARK

Leadership Education in Neurodevelopmental Disabilities and Related Disorders (LEND) fellows representing four professions (audiology, physical therapy, psychology, and speech and language pathology) completed their community leadership projects with HHI in 2017-2018. The projects focused on two programs: the Breastfeeding-friendly Shelter Initiative and the Safe Physical Activity and Recreation for Kids (SPARK) program.

Fellow Cally Orme, MS, CF-SLP, (speech and language pathology) surveyed mothers about feeding challenges children experience while living in shelter, including breastfeeding. After collecting this information, she created family- and staff-friendly resources to support developmentally appropriate feeding and nutrition and made recommendations for how to address the challenges in a follow-up LEND project (currently underway).

For the second project, fellows conducted focus groups with mothers in shelter to assess their impressions of the impact of the SPARK program on their children who participate. Mothers said their children who participated in SPARK learned stress management skills, leadership, independence, structure, respect, teamwork and emotion regulation. They said benefits included their children were happier, more worn out physically and slept better because of SPARK.

Mothers also made suggestions: offering activities for kids of different ages (younger kids vs. tweens), holding SPARK more than once a week and giving updates on children’s performance at the end of SPARK sessions. LEND fellows are exploring the feasibility of those ideas as a follow-up step.

Fellows Paige Seegan (psychology), Kristen Toole (audiology), Chelsea Sedeyn, MS, CF-SLP (speech and language pathology), Elizabeth Balance (physical therapy) and Melissa Maye, MA (psychology) led the SPARK project.