157756 Differential impact of WIC peer counseling programs on breastfeeding across the state of Maryland

Tuesday, November 6, 2007

Susan M. Gross, PhD, MPH, RD , Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, Johns Hopkins University, Reisterstown, MD
Joy P. Nanda, DSc, MS, MHS , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Marycatherine Augustyn, PhD , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
Linda Kelly , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
David M. Paige, MD MPH , Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
Breastfeeding rates among Maryland's WIC participants are lower than the Healthy people 2010 goals. This analysis examined breastfeeding rates in the Maryland WIC Program by differential breastfeeding peer counseling program participation. Three study groups were compared: Peer Counselor (PC) Group; Lactation Consultant (LC) group; and a Comparison Group (CG). Breastfeeding rates for three exposure groups were compared by analyzing data for 31, 656 infants enrolled in the Maryland WIC Program.

The majority of participants were non-Hispanic African Americans averaging 26 years of age, lived below poverty level, participated in the medical assistance program, and registered during the first two pregnancy trimesters. At the time of WIC registration post-natally, their infants were on average, 31 days old.

The prevalence of breastfeeding at the time of infant registration into WIC (aka certification) was 30%. The exclusive breastfeeding rate in this population was 4.8%. Thirty-five percent of infants in the PC group compared to 28% in the LC group, and 23% in the comparison group, were breastfeeding at certification (p<0.001). Exclusive breastfeeding rate was 5.7% for the PC group, 3.7% for the LC group and 4.1% of the comparison group (p<0.001). Multiple regression analysis, controlling for demographic and health variables, showed that the odds of any or exclusive breastfeeding among PC exposed infants was 26% greater (O.R. 1.26; 95% CI: 1.18;1.34) and 15% greater (O.R. 1.15; 95%CI:1.01;1.31) respectively, than CG infants. LC exposed infants had lower breastfeeding (any and exclusive) rates (p<0.05) than the CG.

Learning Objectives:
1. Describe how breastfeeding patterns differ across WIC agencies in the state of Maryland. 2. Recognize the impact of the Maryland WIC Breastfeeding Peer Counselor Program on exclusive breastfeeding rates among WIC participants in Maryland.

Keywords: Breast Feeding, Peer Counselors

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.