196403 A Quasi-Experimental Evaluation of a Breastfeeding Support Program for Low Income Women

Wednesday, November 11, 2009

Beth H. Olson, PhD , Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
Steven J. Haider, PhD , Department of Economics, Michigan State University, East Lansing, MI
Lenisa Vangjel, MA , Department of Economics, Michigan State University, East Lansing, MI
Tracie A. Bolton, MS, RD, IBCLC , Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI
Jonathan G. Gold, MD , Department of Pediatrics and Human Medicine, Michigan State University, East Lansing, MI
Objective: We examined the effectiveness of a peer counseling breastfeeding support program for low income women in Michigan who participate in WIC. Methods: Because there was more demand for services than could be met by the program, many women who requested services were not subsequently contacted by a peer counselor. We used a quasi-experimental methodology that utilized this excess demand for services to estimate the causal effect of the support program on several breastfeeding and health outcomes. We relied on data derived from administrative and survey-based sources. Results: After providing affirmative evidence that our key assumption is consistent with the data, we estimated that the program caused the breastfeeding initiation to increase by about 27 percentage points and the mean duration of breastfeeding to increase by more than 3 weeks. Gastrointestinal disease in the first 12 months was diagnosed in 29% of the treatment vs. 35% of the control group, and lower respiratory disease was diagnosed in 36% of the treatment vs. 38% of the control group. The treatment group had more healthy visits than control in the first year of life. Conclusions: The support program we evaluated was very effective at increasing breastfeeding among low income women who participate in WIC. There was some evidence that health outcomes were also improved. Given the substantial evidence that breastfeeding is beneficial for both the child and mother, the peer counseling breastfeeding support program should be subjected to a cost/benefit analysis and evaluated at other locales.

Learning Objectives:
Describe the benefits to both breastfeeding rates and infant health of a peer counseling breastfeeding support program.

Keywords: Breastfeeding, Peer Counselors

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Olson BH, Haider SJ, Vangjel MA, Bolton TA, Gold JG. A Quasi Experimental Evaluation of a Breastfeeding Support Program for Low Income Women. Maternal and Child Health (in press.) Bolton TA, Chow T, Benton PA, Olson BH. Characteristics Associated With Longer Breastfeeding Duration: An Analysis of a Peer Counseling Support Program. Journal of Human Lactation (in press.) Olson BH, Horodynski MA, Brophy-Herb HE, Iwanski K. Health Professionals' Perspectives on the Infant Feeding Practices of Low Income Mothers. Journal of Maternal and Child Health (in press.) Brophy-Herb HE, Silk K, Horodynski MA, Mercer L, Olson BH. Key theoretical frameworks for intervention: Understanding and Promoting Behavior Change in Parent-Infant Feeding Choices in a Low-Income Population. Journal of Primary Prevention (in press). Silk K., Horodynski MA, Brophy-Herb HE, Olson BH. Strategies to Increase Health Literacy in The Infant Feeding Series (TIFS): A Six-Lesson Curriculum for Low-Income Mothers. Health Promotion Practice (in press). Horodynski M, Olson B, Brophy-Herb H, Silk K, & Shirer K. The Infant Feeding Series (TIFS) Curriculum. Journal of Nutrition Education and Behavior. J Nutr Educ Behav. 2008 May-Jun;40(3):187-8. Greene S, Wolfe E, Olson BH. Assessing the Validity of Measures of an Instrument Designed to Measure Female Employees’ Perceptions of Workplace Breastfeeding Support. Breastfeed Med. 2008 Sep;3(3):159-63. Greene S, Olson BH. The Development of an Instrument to Measure Female Employees’ Perceptions of Workplace Breastfeeding Support. Breastfeed Med. 2008 Sep;3(3):151-7. Horodynski M, Olson BH, Arndt MJ, Brophy-Herb H, Shirer K, Runoavaara D, Benton P, Padonu G, Weir G, Shemanski R. Mother’s Decisions Regarding When and Why to Introduce Solid Foods to Their Infants: Influencing Factors. (2007) J Comm Health Nurs 24(2), 2007. Meier ER, Olson BH, Benton P, Eghtedary K, Song W.O. A Qualitative Evaluation of a Breastfeeding Peer Counselor Program (2007). J Hum Lact, 23:262-268.
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.

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