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Grant Writing in a Small Town

Sally Myer
From: LEAVEN, Vol. 42 No. 1, February-March 2006, p. 17.

What would you do with $1,400 to promote breastfeeding in your community?

As a breastfeeding advocate, I've daydreamed about what I would do to support breastfeeding in my community (a town of about 8,000 people) if I had a sizable amount of money. When I saw a notice in my community newspaper regarding a local Public Health Department grant that was being offered, I dove right in. I had never applied for a grant before, so in the two months I had to complete it, I did some research. I was fortunate enough to be awarded $1,400 (US) in August 2005. I'd like to tell you about my project.

I have always believed that the US exclusive breastfeeding rate of 13.3 percent at six months (US Centers for Disease Control National Immunization Survey 2003) doesn't reflect how many mothers would like to be exclusively breastfeeding. There are many mothers who would like to breastfeed as recommended, but feel "forced" to quit when they encounter obstacles they are unable to overcome. I decided the focus of my grant application would be on reducing obstacles to feeding local babies the healthiest way. The 2005 American Academy of Pediatrics policy statement, "Breastfeeding and the Use of Human Milk," lists 10 evidence-based obstacles to breastfeeding. Strategies of this grant project addressed each of the 10 obstacles.

I titled my grant "Promoting Optimal Feeding of Infants and Young Children in Red Willow County [Nebraska USA]." In the first draft of my application, I used the word "Breastfeeding" in the title, instead of "Optimal Feeding." Something about it just didn't feel right, so I consulted with my friends and peers on the Nebraska Leader electronic discussion group. They offered very helpful suggestions that I ultimately utilized and believe were instrumental in my success. One suggestion was to remove the word "breastfeeding" in as many places as feasible throughout the grant application, including the title.

A Leader shared that in her grant application experience, proposals found better acceptance when use of the word breastfeeding was minimized. I thought about how the LLL Founders avoided the use of the word "breastfeeding" in the name of their fledgling organization. Could it be that prejudice still exists 50 years later? It's hard to imagine that some in our US culture still have discomfort with any mention of breastfeeding, but it appears to be so. Because of their personal discomfort, some folks very effectively act as "gatekeepers" and hinder the promotion of breastfeeding.

As a registered nurse, I am more than familiar with "gatekeepers" to breastfeeding promotion in the health care system. Based on that suggestion, I tried removing the word breastfeeding in most places in my grant application. While "gatekeepers" might label a request for support of breastfeeding fanatical, no one can argue with efforts to promote optimal feeding of infants and small children.

Another great suggestion was to utilize terminology and phrasing found in the WHO-UNICEF Global Strategy for Infant and Young Child Feeding (2003).

The 10 obstacles and my strategies to address them are as follows:

  1. Insufficient prenatal education about breastfeeding.
    Strategy: Donation of five books and a video to the city library so parents can educate themselves. Strategy: Placement of a monthly advertisement in the local newspaper to promote knowledge of and utilization of La Leche League of McCook (Nebraska, USA).
  2. Disruptive hospital policies and practices.
    Strategy: Donation of Clinical Guidelines for the Establishment of Exclusive Breastfeeding (ILCA June 2005) to the local hospital obstetrical unit and to each of the local physicians who provide care to mothers and newborns.
  3. Inappropriate interruption of breastfeeding.
    Strategy: Donation of Medications and Mother's Milk (Pharmasoft 2005) by Thomas Hale to the local physician's clinic and to the hospital obstetrical unit.
  4. Early hospital discharge in some populations, and
  5. Lack of timely routine follow-up care and postpartum home health visits.
    Strategy: Donation of POCKET GUIDE TO THE BREASTFEEDING ANSWER BOOK by Nancy Mohrbacher (LLLI 2005) and Clinical Guidelines for the Establishment of Exclusive Breastfeeding (ILCA) to the local hospital home health department that does postpartum home visits.
  6. Maternal employment (especially in the absence of workplace facilities and support for breastfeeding).
    Strategy: Donation of a Lactation Support Package to a local business that expressed interest in making the materials available to their employees. The package, worth over $100 (US), consisted of books, LLL pamphlets, and tear-off sheets and a videotape, provided in a portable storage box.
    Strategy: Packets of information on caring for breastfed babies provided for area child care providers.
  7. Lack of family and broad societal support.
    Strategy: Preparation of a presentation suitable for groups in the community on becoming a breastfeeding-friendly community.
    Strategy: Providing materials for the lending Library of LLL of McCook.
  8. Media portrayal of bottle-feeding as normative.
    Strategy: Previously mentioned newspaper advertisement for LLL of McCook. It's large enough to share tidbits of breastfeeding information.
  9. Commercial promotion of infant formula through distribution of hospital discharge bags or discounted formula.
    Strategy: Provide packets of information on the WHO Baby-Friendly Hospital Initiative and applicable portions of the Center for Disease Control's Guide to Breastfeeding Interventions to the local hospital's five-member administrative council, including the chief executive officer.
  10. Misinformation and lack of guidance and encouragement from health care professionals.
    Strategy: Donation of the Breastfeeding Handbook for Physicians (AAP 2005) and POCKET GUIDE TO THE BREASTFEEDING ANSWER BOOK to the local physician's clinic, and Breastfeeding the Newborn (Mosby 2002) by Marie Biancuzzo to the hospital obstetrical unit.

I've had a great time carrying out these strategies, and I was able to order most of the items from the LLLI Catalogue. I also baked cookies to donate with the items, which made it lighthearted and fun. The opportunity to do this was like a dream come true for this breastfeeding advocate. I would encourage any Leader to dive right in as I did.

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