Anne Merewood, MA, IBCLC¹, Barbara L. Philipp, MD, IBCLC¹, Laura Beth Chamberlain, BA², Kirsten Malone, IBCLC², John T. Cook, PhD¹, and Howard Bauchner, MD¹. (1) Division of General Pediatrics, Boston University School of Medicine, Maternity Building, 4th Floor, 91 East Concord St., Boston, MA 02118, 617-414-6455, anne.merewood@bmc.org, (2) The Breastfeeding Center, Boston Medical Center, YACC 5, 860 Harrison Ave, Boston, MA 02467

Background: US breastfeeding rates among African Americans and women of low SES are low, and African Americans have high numbers of premature births. Among premature infants, the benefits of human milk are particularly crucial. Peer counseling programs have been shown to increase breastfeeding duration among term infants from underprivileged groups in a variety of settings. Boston Medical Center is an inner-city hospital with WHO/UNICEF Baby-Friendly status. Objective: To determine whether peer counselors impact breastfeeding duration in the Neonatal Intensive Care Unit (NICU) of an inner city hospital. Methods: Premature singleton infants whose mothers intended to breastfeed were randomized to intervention (IG) or control (CG) group. IG received breastfeeding peer support within 72 hours of birth and weekly for 6 weeks. CG received standard BMC NICU care. A research assistant blind to group allocation assessed feeding status at 2, 4, 8, and 12 weeks. Results: 38 mother/infant pairs were randomized to IG and 38 to CG. The groups were similar in all important demographic and social variables. In bivariate analyses of subgroup data, IG mothers were significantly more likely than CG mothers to feed any amount of breast milk at 4 (P=.01) and 8 (P=.03) weeks. At 4 weeks 97% of IG were feeding any amount of breast milk compared with 77% of CG. In bivariate analyses of data pooled from all contact points, IG mothers were significantly more likely to offer breastmilk (P<.001). Moreover, in random effects multi-level logistic regression models, IG mothers had odds of breastfeeding 5.3 times as great as CG mothers at any contact point. Conclusions: This study, the first of its kind using an experimental design, indicates that NICU-based peer counselors positively impact breastfeeding duration rates in premature infants.

Learning Objectives:

At the conclusion of the session, the learner will be able to
• Identify barriers to breastfeeding among impoverished mothers of NICU infants
• Describe the role of peer counselors in the NICU
• Describe the positive effect of breastfeeding peer counselors on breastfeeding duration among premature infants.

Keywords: Breastfeeding, Low Birthweight

Presenting author's disclosure statement:
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.