Impact of Education and Training on Type of Care Provided by Breastfeeding Peer Counselors (original) (raw)
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International Breastfeeding Journal, 2011
Background Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. Methods This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while b...
BMC Pregnancy and Childbirth
Background One approach for improving breastfeeding support and alleviating breastfeeding disparities is the implementation of a clinic-based peer counselor. Our objective was to assess the “real life” effects of an autonomous peer counselor who provides tailored support to low-income, minority women based on individual needs rather than a pre-determined research protocol. Methods This is a secondary analysis of a prospective cohort study of women receiving publicly funded prenatal care during the 6 months before and after introduction of a peer counselor in a single prenatal clinic. The peer counselor provided one-on-one antenatal and postpartum lactation support. Electronic medical record and survey data were collected. The primary outcome was breastfeeding continuation at 6 weeks postpartum. Secondary outcomes included breastfeeding comfort, confidence, and training satisfaction, any breastfeeding, and total breastfeeding duration. Bivariable and multivariable analyses were perfo...
Women, Infant and Children (WIC) Peer Counselor Contact with First Time Breastfeeding Mothers
Public Health Nursing, 2014
Objective: This study was designed to determine whether singleton women who had not previously breastfed and who had a women, infant and children (WIC) peer counselor were more likely to initiate breastfeeding than women not exposed to the WIC peer counselor. Design and Sample: The retrospective cross-sectional study used data from the 2009 Texas Department of State Health Services (DSHS) WIC Infant Feeding Practices Survey (IFPS) administered through 73 local WIC agencies. Of the 5,427 responses to the 2009 Texas DSHS WIC IFP Survey, 56.6% (N = 3,070) were included in this study. Measures: The Texas DSHS WIC IFPS, a 55-item survey with multiple-choice and two open-ended questions, was used to evaluate breastfeeding beliefs, attitudes, and practices among women receiving WIC services. Results: Women who had peer counselor contact during pregnancy, in the hospital, and after delivery were more likely to initiate breastfeeding than women without such contacts, OR = 1.36, 2.06, 1.85, respectively. Conclusion: Womens decision to initiate breastfeeding is significantly associated with WIC peer counselor contacts. Continued WIC peer counselor program services may increase breastfeeding initiation rates among WIC participants.
Review: Breastfeeding Peer Counseling: From Efficacy Through Scale-Up
Journal of Human Lactation, 2010
An increasing number of publications have evaluated various breastfeeding peer counseling models. This article describes a systematic review of (a) the randomized trials assessing the effectiveness of breastfeeding peer counseling in improving rates of breastfeeding initiation, duration, exclusivity, and maternal and child health outcomes and (b) scientific literature describing the scale-up of breastfeeding peer counseling programs. Twenty-six peer-reviewed publications were included in this review. The overwhelming majority of evidence from randomized controlled trials evaluating breastfeeding peer counseling indicates that peer counselors effectively improve rates of breastfeeding initiation, duration, and exclusivity. Peer counseling interventions were also shown to significantly decrease the incidence of infant diarrhea and significantly increase the duration of lactational amenorrhea. Breastfeeding peer counseling initiatives are effective and can be scaled up in both develope...
Journal of human lactation : official journal of International Lactation Consultant Association, 2015
Whereas breastfeeding initiation rates have risen in all groups throughout the country, rates of breastfeeding duration have changed more slowly. Peer counseling has had some success in sustaining breastfeeding, but with intensive programs and variable effects. We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and self-efficacy with the intervention. One hundred twenty prenatal women underwent stratified randomization based on breastfeeding attitude, measured by the Iowa Infant Feeding Attitude Scale (IIFAS). The peer counselor contacted the intervention group by telephone or in clinic up to 4 months postdelivery. Study groups were compared on breastfeeding outcomes, adjusting for IIFAS strata, and on interactions with self-efficacy. One hundred three women were followed to at least 1 month. Women with positive attit...
Public Health Nutrition, 2014
Objective: Peer counselling (PC) programmes have been shown to improve breastfeeding outcomes in populations at risk for early discontinuation. Our objective was to describe associations between programme components (individual and combinations) and breast-feeding outcomes (duration and exclusivity) in a PC programme for low-income women. Design: Secondary analysis of programme data. Multivariable-adjusted Cox proportional hazards models were used to examine associations between type and quantity of peer contacts with breast-feeding outcomes. Types of contacts included in-person (hospital or home), phone or other (e.g. mail, text). Quantities of contacts were considered 'optimal' if they adhered to standard programme guidelines. Setting: Programme data collected from 2005 to 2011 in Michigan's Breastfeeding Initiative Peer Counseling Program. Subjects: Low-income (n 5886) women enrolled prenatally. Results: For each additional home, phone and other PC contact there was a significant reduction in the hazard of discontinuing any breast-feeding by 6 months (hazard ratio (HR) = 0·90 (95 % CI 0·88, 0·92); HR = 0·89 (95 % CI 0·87, 0·90); and HR = 0·93 (95 % CI 0·90, 0·96), respectively) and exclusive breastfeeding by 3 months (HR = 0·92 (95 % CI 0·89, 0·95); HR = 0·90 (95 % CI 0·88, 0·91); and HR = 0·93 (95 % CI 0·89, 0·97), respectively). Participants receiving greater than optimal in-person and less than optimal phone contacts had a reduced hazard of any and exclusive breast-feeding discontinuation compared with those who were considered to have optimum quantities of contacts (HR = 0·17 (95 % CI 0·14, 0·20) and HR = 0·28 (95 % CI 0·23, 0·35), respectively). Conclusions: Specific components of a large PC programme appeared to have an appreciable impact on breast-feeding outcomes. In-person contacts were essential to improving breast-feeding outcomes, but defining optimal programme components is complex.
Reactions of Low-Income African American Women to Breastfeeding Peer Counselors
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG
To examine the influence of breastfeeding peer counseling on the breastfeeding experiences of African American mothers who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Qualitative study using focus groups. Two WIC clinics in Southeast Wisconsin were used for recruitment and data collection. A convenience sample of nine African American mothers participated in one of two focus groups. The women responded to a series of open-ended questions about their breastfeeding experiences and the effect of breastfeeding peer counselors (BPCs). Content and thematic analyses were used to analyze patterns related to the influence of BPCs on breastfeeding. Four themes were categorized: Educating With Truth, Validating for Confidence, Countering Others' Negativity, and Supporting With Solutions. Mothers in this study expressed positive reactions to educational, emotional, and social support from BPCs. The mothers noted that the contact they ha...
Effect of Counseling on Breast Feeding Practices
Indian Journal of Child Health, 2014
Background: National Family Health Survey-3 data show that the initiation of breastfeeding within 1 h is only 24.5%, whereas the exclusive breastfeeding rates in children <6 month is only 46.4%. Objective: The present study was planned to assess the effect of counseling on breast feeding practices, especially early initiation and sustained exclusive breast feeding (EBF). Method: Cases were pregnant mothers attending antenatal clinic of Kamla Raja Hospital (KRH) (n = 154). Control group comprises of mothers who delivered at government maternity hospital other than KRH (n = 140). The cases were enrolled using structured proforma with written consent. All mothers in case group were counseled antenataly for advantages of early initiation of breastfeeding and helped to initiate breast feeding immediately after birth and again counseled at discharge, on follow-up at the end of 1 st month and 3 rd month for EBF. The effect was evaluated at end of 1 st , 3 rd and 6 th month in terms of breast feeding practices. Counseling skills used were according to infant and young child feeding practice guidelines. At the end of 3 rd month, group and individual counseling was done in case group. In control group, the breast feeding practices were recorded at 1, 3 and 6 month after delivery without any counseling. Results: There was significant increase in early initiation and EBF since birth in case group than in control group with odds ratio of 26. On follow-up at the end of 1 st month, 83% (p = 0.001) mothers were practicing EBF in case group, which increased to 86% (p = 0.01) and to 97% (p = 0.006) at the end of 3 rd and 6 th month, respectively. Effect of counseling in case group for EBF was more in primiparous (78%, 81%, 91%) than in multiparous (48%, 55%, 61%) (p = 0.001, 0.006 and 0.0004 at end of 1 st , 3 rd and 6 th month respectively). On comparing group and individual counseling given at end of 3 rd month, the effect evident at 6 th month shows, respectively; group counseling was more effective (99%) than individual counseling (95%, p = 0.002). Conclusion: Counseling before delivery and at regular intervals was of utmost importance for early initiation and sustained exclusive breastfeeding. This influenced primiparous mothers more. Group counseling had more impact than individual counseling.