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Results of the User Surveys

Strategic Planning Committee
User Survey Team
From: LEAVEN, Vol. 42 No. 4, October-November-December 2006, pp. 92-94

As part of the ongoing Strategic Planning project, La Leche League International conducted a survey of women in the USA and English-speaking Canada to assess knowledge and attitudes about La Leche League. The survey was designed and conducted by a workgroup comprised of LLLI Board members, Leaders from the US and Canada, and Josh Bernoff, a research analyst who is on the LLLI Management Advisory Council.

The results reveal some good news. Women who contact La Leche League are satisfied with the mother-to-mother support and other services we provide and find them helpful. In addition, these women have far more positive attitudes toward breastfeeding than those who do not know about us. Good job, Leaders!

We surveyed two groups of women through an online survey to answer two key categories of questions. First, "How do women feel about their experiences with LLL, and how do we affect their attitudes about breastfeeding?" Answers to this first question show how effectively LLL addresses the needs of women who contact us. The answers to the second question "How do women in general (not just those who have had contact with LLL) feel about breastfeeding and LLL?" show how successful LLL is at reaching women and why some women do not use our services. The two groups we surveyed were: (1) women whom Leaders asked to participate and to further distribute the survey and (2) a random sample of women generously provided free of charge by comScore, an online survey provider with a national (USA) reputation. Both groups answered the same questions.

We call the two surveys the Leader Contact survey and the Online Sample – together we refer to them as the User Surveys. The surveys were designed to reach women who have a child five years old or younger, or who are pregnant, or who are planning to become pregnant. More than 5,500 women participated in the Leader Contact survey and more than 1,000 women participated in the Online Sample

We now have plans to roll these surveys out to other countries throughout the world. The next countries to be surveyed are Great Britain, France, Spain, Mexico, French Canada, Ireland, and New Zealand. Other countries will follow as translations and ways to distribute the surveys become available. In the US and Canada, over 80 percent of people are online, so an online survey yields a representative sample. In other countries, a different approach may be needed.

In addition to the positive results noted above, the User Surveys revealed areas in which LLL is falling short of our goal to help all mothers who want to breastfeed their babies. Perhaps the most important of these shortcomings is that many women, especially women who are planning their first pregnancy or who are pregnant for the first time, are not aware of the existence of LLL. In the Online Sample, 34 percent of women had never heard of LLL. Among women from the Online Sample who were pregnant, or planning to become pregnant, for the first time, 74 percent had never heard of La Leche League prior to completing the survey. (See chart one and chart two)

In an earlier survey of Leaders, some Leaders expressed grave concern that LLL has a negative image. The User Surveys did not support this concern. Mothers who had contacted LLL rated their experiences as generally positive. Of those women who knew about LLL but had not contacted us, only eight percent indicated that they had heard negative things about LLL. The number of women with negative attitudes toward LLL is so small that it has very little impact on our ability to help mothers. (See chart three.)

In the Leaders' Survey, Leaders also expressed concern that LLL does not reach diverse groups of mothers. The User Surveys did confirm that LLL contacts some groups of mothers more successfully than others. Respondents in the Leaders' Survey had higher average household incomes, were more likely to be white/Caucasian, were more likely to be married, were less likely to be pregnant with or planning to become pregnant with their first child, and were less likely to work outside the home than the women who participated through the Online Sample.

The User Surveys revealed that how a mother feeds her first baby is a major determinant of how she will choose to feed her subsequent children. This suggests that increased awareness about LLL among women who are not yet pregnant or who are pregnant for the first time may help to increase breastfeeding initiation and duration rates.

In addition, women reported that their husbands or partners, their friends, and books or magazines were the biggest influences on their choice to breastfeed or formula feed their first child. This suggests that we need to increase awareness of LLL not only among women, but also among fathers. We also need to increase the visibility of LLL in books and magazines targeted toward pregnant women and mothers. (See chart four.)

For women who did contact LLL, the main source of referrals was word-of-mouth. Women were referred to LLL most often by a friend, doctor, nurse, or lactation consultant. Open-ended responses to this question included many women who had been first told about LLL by prenatal instructors and midwives. This suggests that we also need to increase awareness of LLL among health care professionals in order to help more mothers to breastfeed. (See chart five.)

After answering questions about breastfeeding and LLL, the women who were not previously aware of LLL were provided with a description of LLL and the services we provide. They were asked whether they would contact LLL for breastfeeding information in the future. Only a small percentage of women (13 percent) said they would. Another 43 percent said they might contact LLL, but only if they had problems with breastfeeding. Most of the women who planned to breastfeed, but said that they would not contact LLL, indicated either that they did not need any additional information about breastfeeding, or that LLL did not sound like their kind of organization. These results suggest that, while mother-to-mother support is highly effective for those who use it, many mothers prefer to receive information and support for breastfeeding from their husband or partner, friends and family, books, magazines, and the Internet. These women may also not realize that LLL is much more than just a provider of breastfeeding information. They may not understand the benefits of the support and encouragement of other women. We need to work toward increased awareness of the value of mother-to-mother support. In addition, a top-quality Web site devoted to providing the best in breastfeeding information might help us to reach the mothers who prefer to receive breastfeeding support from the Internet.

Once the User Surveys have been conducted throughout other parts of the world, we will be able to see whether the results are similar to those from the USA and English-speaking Canada. The results of all the surveys will provide critical information for the LLLI Strategic Planning process and will greatly enhance our ability to fulfill the LLLI Mission: To help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information, and education and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother.

The workgroup is grateful for the expertise to this project brought by Josh Bernoff and the hard work by everyone involved. We are also grateful to all those women who took the time to complete the survey.

(This article provides only a brief overview of the data generated by the User Surveys. For more details, see

Editor's note: The charts that accompany this article can be found on the Community Network in the Publications Discussion Library.

Members of the Strategic Planning
Committee User Survey Team are:

Leslie Ayre-Jaschke, AB Canada
Josh Bernoff, MA USA
Don Buckley, CT USA
Cindy Harmon-Jones, TX USA
Nan Jolly, South Africa
Laura LaRocca, ON Canada
Gisele Laviolle, France
Sally Martin, MA USA
Waleska Porras, Costa Rica
Shelly Stanley, NY USA
Carmen Vandenabeele, France

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