Impact of a Telephone Based Peer Counselor Program on Breastfeeding Duration and Exclusivity

Background: Breastfeeding peer counseling has been shown to increase initiation and duration in clinical settings and areas with historically low breastfeeding rates. However, the impact of peer counselors in states with high breastfeeding rates is relatively unexplored.

Goal: To determine the effectiveness of a telephone based peer counseling program among English and Spanish speaking WIC participants in Oregon.

Methods: Between July 2005 and July 2007, 1,933 pregnant women receiving services at one of four local WIC agencies were recruited and randomly assigned to one of three groups; the control group had no contact with a peer counselor, the low intensity group received four scheduled calls, and the high intensity group received eight calls. Data were collected on initiation, duration and exclusivity of breastfeeding. Peer counselors kept detailed logs of each phone call with participants.

Results: Mothers who had contact with a peer counselor were more likely to initiate breastfeeding and partially breastfed an average of five weeks longer than those who did not (p<.01). However, duration of exclusive breastfeeding and the percent of women exclusive breastfeeding for six months were not significantly different. When data were split by mother's spoken language, only Spanish speaking mothers had significant increases in breastfeeding outcomes. The most common reason mothers gave for introducing formula was that breast milk alone did not seem to fill the baby.

Discussion: Peer counseling may be an effective means of increasing breastfeeding duration among specific subgroups of WIC participants even in states that already enjoy high breastfeeding rates.