Online Program

320206
Does peer counselor support influence the rate of breastfeeding initiation and duration in an upstate New York WIC population?


Tuesday, November 3, 2015

Ann M. Dozier, PhD, RN, Public Health Sciences/Social and Behavioral Sciences, University of Rochester, Rochester, NY
Barbara Suter, RN, MPH, Public Health Sciences/Social and Behavioral Sciences, University of Rochester, Rochester, NY
Kelly Thevenet-Morrison, MS, Public Health Sciences/Social and Behavioral Sciences, University of Rochester, Rochester, NY
Joseph Duckett, Public Health Sciences/Social and Behavioral Sciences, University of Rochester, Rochester, NY
Lynn Edmunds, DrPH, MS, RD, Division of Nutrition, New York State Department of Health, Menands, NY
Jackson Sekhobo, PhD, MPA, Division of Nutrition, New York State Department of Health, Menands, NY
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.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe peer counseling support characteristics associated with higher rates of breastfeeding initiation and duration.

Keyword(s): Breastfeeding, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal investigator of multiple federally funded grants focusing on breastfeeding initiation, duration and exclusivity. Among my scientific interests has been the development of strategies to increase breastfeeding rates in minority populations. I am a doctorally-prepared nurse.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.