Offering breastfeeding support services from hospital discharge to child's first birthday: Increases in exclusive breastfeeding rates and 2, 6, and 11 months from delivery, 2004 to 2009

Background: The Sacramento County Enhanced Community Lactation Assistance (CLA) Project began in 2004 with new strategies to increase breastfeeding initiation and duration. The following interventions were implemented to impact those decision points when women make infant feeding decisions: Prenatal and post-partum breastfeeding classes; lactation assistance at hospital discharge; additional support within 72 hours after discharge to mothers at high risk of discontinuation; and ongoing lactation consultant services and other supports, such as free breast pump loans, through one year of age. Professional lactation and peer counselor support was made available by phone, in a WIC clinic, or in the home.

Methods: Vouchers are issued based on project staffs' assessment of mothers' current breastfeeding status. Information on the type of voucher and date issued are entered into the Statewide WIC Integrated Computer System (ISIS). Breastfeeding rates were calculated by examining through ISIS the number of vouchers indicating exclusive breastfeeding versus all other types of vouchers, at 2, 6, and 11 months from child's birth.

Results: The CLA Project provided services to over 7,000 infants. From 2004 to 2009, exclusive breastfeeding rates at 2 months of age increased from 15.6% to 25.8%; for infants at 6 months of age from 9.7% to 18.4%; at 11 months of age from 5.0% to 14.8%.

Conclusions: Mothers need breastfeeding help in the critical period of 2 to10 days after delivery. Evidence from the CLA Project suggests that with continuous professional and paraprofessional support, significantly more mothers will breastfeed successfully and for longer periods of time.