177886 Breastfeeding Peer Counseling: The occurrence of Non Initiation and minimal duration

Monday, October 27, 2008

Marycatherine Augustyn, PhD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Caitlin Cross-Barnet, MA , Department of Population, Family and Reprodutive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Angie Ting Wai Wong, BA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Dr. Joy P. Nanda, DSc, MS, MHS, MBA , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Susan M. Gross, PhD, MPH, RD , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Amy Resnik, MS, RD, CSP, LDN , Maryland WIC Program, Maryland State Department of Health and Mental Hygiene, Balitmore, MD
David M. Paige, MD MPH , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Introduction The Maryland WIC Breastfeeding Peer Counseling Program is designed to increase breastfeeding initiation, duration and exclusivity. Many WIC clients, however don't initiate breastfeeding or prematurely abandon it despite Peer Counseling (PC). We report qualitative analysis results of emergent themes associated with non-initiation (NI) and early termination (ET). Design A convenience sample of WIC Breastfeeding PC clients with infants less than or equal to 1 year is being interviewed at 3 geographically representative Maryland PC sites. Current breastfeeders, ETs, and NIs are included. Preliminary Results All NIs and most ETs were prenatally counseled by WIC PCs in early pregnancy. ETs were postnatally counseled. Common themes include: knowledge that “breastfeeding is best” acquired from WIC PCs, health care providers, and/or reading; and limited friend/family modeling. Differing themes include ETs greater likelihood to have pre-delivery breastfeeding plans and father's involvement, and lesser likelihood to have pre-delivery medical conditions. Reasons for non-initiation include: belief that breastfeeding would hurt, discomfort with the idea of breastfeeding, and either being doctor instructed not to breastfeed or believing that taking medication renders breastfeeding unsafe for the baby. Discussion Identified differences and reasons for non-initiation indicate that PCs should focus on mistaken perceptions, including breastfeeding contraindications and assumed incidence of pain. The finding that except for the PCs, both groups have limited breastfeeding modeling indicates that in some cases, this deficit may be overcome so that women will try breastfeeding. Peer counselors should additionally exploit the common knowledge of the value of breastfeeding to translate knowledge to behavior.

Learning Objectives:
Describe difference between and similarities of breastfeeding non-initiators and early terminators in the Maryland WIC Program Identify reasons for non-initiation of breastfeeding in the Maryland WIC population Apply identified differences and similarities to how peer counselors should focus their efforts in the MD WIC Peer Counseling Program

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Development of qualitative program evaluation and field guides; interviewed participants; wrote abstract.
Any relevant financial relationships? No

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.

See more of: Addressing the Food and Nutrition Challenges of Women, Infants, and Children
See more of: Food and Nutrition