Does peer counselor support influence the rate of breastfeeding initiation and duration in an upstate New York WIC population?

background:  Breastfeeding (BF) positively impacts infants’ and mothers’ health. Lower income mothers experience lower BF initiation and duration rates. To improve these rates many WIC programs use peer counseling (PC), prenatal and/or post-partum BF support (telephone; face-to-face contact; mailings). While this evidence based intervention improves BF rates its implementation varies (e.g. only some elements implemented) resulting in suboptimal impact. Effectiveness studies of current programs are warranted. We evaluated BF initiation and duration rates for women enrolled in a large local WIC program who received different levels of PC support.

methods: Using a dataset containing 2 years of PC data (4/1/2009-3/30/2011) merged with New York State’s (NYSDOH) WIC data resulted in 4098 cleaned, singleton records with outcome indicators (initiation; 30-day duration). PC contact fields were analyzed with BF outcomes using logistic regression, controlling for maternal demographics (age, education, race, smoking status, gestational age, pregnancy interval, high risk zip codes and poverty ratio).

results: Mothers with PC contact were 3.8 times (95%CI:3.3-4.4) more likely to initiate; BF initiators were 1.7 times (95%CI:1.5-2.1) more likely to be doing some BF at 30 days (vs. mothers without contact). Informational mailings, found to be a common type of contact, were not associated with better outcomes.

conclusions: HP 2020 calls for the proportion of infants ‘ever breast fed’ to increase from 76.5% to 81.9%. Among our low income mothers having even some PC contact significantly increased both BF initiation and early duration.