Association of Women, Infant, and Children (WIC) Peer Counselor Interventions with Breastfeeding in Texas

Background: Breastfeeding rates in the United States are lower than national goals particularly in low-income women, women with less than a high school education, and women from minority populations. Utilization of peer counselors among populations with the greatest disparities has been shown to increase breastfeeding rates. Breastfeeding rates in Texas WIC mothers are well below the national WIC breastfeeding rates. The 2009 Texas WIC Infant Feeding Practices Survey, reported that 73.4% of mothers initiated breastfeeding, 29.3% reported breastfeeding for six months or longer, and 11.3% breastfed for twelve months or longer. Purpose: The purpose of the study is to determine which WIC peer counselor interventions influence mothers to breastfeed in Texas.

Methods: The study uses a cross-sectional design to determine which Texas WIC peer counselor interventions were associated with mothers' decisions to breastfeed. Analysis of de-identified data was restricted to mothers who have not breastfed before or are first time mothers. Odds ratios with associated confidence intervals and P values were calculated for each of the seven possible peer counselor intervention combinations.

Results: A total of 57.8% of the surveys (n=3,173) met the study inclusion criteria. Of the seven possible peer counselor interventions five were associated with increased breastfeeding, OR (1.28-1.93) and P values (.000-.002). The peer counselor interventions that were associated with the mothers being more likely to breastfeed were; during pregnancy, hospitalization, after delivery and in combination were; during pregnancy, hospitalization, and after delivery, and during pregnancy and after delivery. Discussion/Recommendations: Peer counseling implemented during the prenatal and perinatal period is a viable activity shown to increase breastfeeding rates in women who are vulnerable due to income, education, and race. Comprehensive examination of WIC's data may support evidence based interventions, additional areas of program effectiveness and improve program funding.