Locally Designed Home Visiting Program Improves Infant Breastfeeding; Toddler Obesity Persists

Background

Home visiting is a long-standing service delivery strategy used to promote positive maternal and child health and development.  We conducted a quasi-experimental design study to determine the impacts of a locally designed home visiting program on breastfeeding initiation, duration, and healthy weight, among other outcomes. 

Methodology

This six-year evaluation employs mixed methods to assess program implementation and outcomes.  Findings presented here are based on a longitudinal survey designed to examine outcomes at 12, 24 and 36 months postpartum. The study includes an intervention group of mothers who received home visiting (n = 454) and a comparison group of mothers from the same community who were not offered the program (n = 280).  A majority of the sample are low-income Latino immigrants with less than a high school education.

Results

Findings at 12 months demonstrate that mothers who received home visiting had a higher likelihood of attempting breastfeeding and exclusively breastfeeding during the first four months postpartum.  At 24 months, however, children in both groups were equally likely to be overweight or obese.  These rates are double national averages for 2- to 4-year-olds (30% vs. 15%), but consistent with benchmarks for low-income Latino children.

Conclusions

Significant breastfeeding findings demonstrate that staff training and program focus have a measurable impact on breastfeeding uptake and success.  Sustainable impacts on healthy weight, however, may require a longer program and a greater focus on the introduction of solid foods, healthy eating, and opportunities for being active, which are critical for this at-risk population.