5264.0: Wednesday, November 15, 2000 - 5:30 PM

Abstract #15018

Home-based peer counseling: Impact on breastfeeding and decreased illness in Mexican infants

Ardythe L. Morrow, PhD1, M. Lourdes Guerrero, MD, MS2, Mekibib Altaye, PhD1, Guillermo Ruiz-Palacios, MD2, and Larry K. Pickering, MD1. (1) Center for Pediatric Research, E.Virginia Medical School & Children's Hosp. of The King's Dghtrs, 855 W. Brambleton Ave, Norfolk, VA 23510, 757-668-6435, amorrow@chkd.com, (2) Instituto Nacional de la Nutricion, Mexico City, Mexico

Breastfeeding promotion is a global priority, requiring both community- and hospital-based initiatives. We compared breastfeeding and infant diarrhea rates before and after instituting home-based breastfeeding peer counseling in periurban Mexico. Methods: From 1988-91, we conducted a study (Cohort 1) in 303 breastfeeding mother-infant pairs residing in San Pedro Martir (approx. pop. 30,000), located on the outskirts of Mexico City. Subsequently, we developed and tested a program to promote breastfeeding through home visiting by peer counselors trained by La Leche League (Morrow et al, Lancet 1999;353:1226-31). In 1998-99, we followed 165 breastfeeding mother-infant pairs in San Pedro Martir (Cohort 2), who were visited 3 times (once during pregnancy, twice in the first 2 weeks postpartum) by a peer counselor. Results: The median duration of breastfeeding was 6 months in Cohort 1 and 15 months in Cohort 2 (p<.001). Exclusive breastfeeding was rare in Cohort 1 but in Cohort 2, the prevalence of exclusive breastfeeding in the past week was 73% at 3 months postpartum. The incidence of infant diarrhea was 3.1 episodes per infant-year in Cohort 1, decreased to 2.0 episodes per infant-year in Cohort 2. Conclusions: The findings of this quasi-experimental study are consistent with our previously published randomized, controlled trial and demonstrate that home-based breastfeeding counseling can have immediate and dramatic impact on breastfeeding behavior and infant health. The findings of this study may be relevant to many developing countries.

Learning Objectives: At the conclusion of the presentation, the participant in this session will be able to: 1. Identify 3 advantages of home-based breastfeeding peer counseling 2. Articulate the evidence base indicating that peer counseling can improve infant health outcomes 3. Identify 3 key issues in the global use or deployment of breastfeeding peer counselors

Keywords: Breast Feeding, Disease Prevention

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA