title: Relationship between perinatal counseling and incidence of breastfeeding in an inner-city population.
abstract: OBJECTIVE
  We hypothesized that the cost of a lactation program can be reduced without significantly affecting the incidence of breastfeeding.
  
  
  METHODS
  We conducted a retrospective analysis of breastfeeding among all 7942 mothers whose neonates were admitted to the well baby nursery at Jacobi Medical Center (JMC) over a 44-month period. We used multiway frequency analysis to compare the incidence of breastfeeding in three successive models of counseling: (1) full-time lactation coordinator, (2) obstetric personnel trained in breastfeeding counseling and full-time lactation coordinator, and (3) obstetric personnel and half-time lactation coordinator. Mothers were further classified into three groups according to location of prenatal care and attendance at breastfeeding education sessions.
  
  
  RESULTS
  Breastfeeding increased with the initiation of education and the involvement of obstetric personnel and did not significantly decrease when the lactation coordinator became half-time. The transition to model 3 resulted in decreased costs without significantly affecting the incidence of breastfeeding. Breastfeeding was significantly associated with counseling by obstetric personnel, with prenatal care at JMC, and with breastfeeding education sessions.
  
  
  CONCLUSIONS
  Involving obstetric personnel in breastfeeding counseling may enhance the effectiveness of a lactation program. In our population, the most cost-conscious model included counseling by trained obstetric personnel and a half-time lactation coordinator.
authors.affiliation: Department of Pediatrics, Albert Einstein College of Medicine, NY, USA.
authors.forename: B K
authors.initials: BK
authors.lastname: Russell
authors.forename: M
authors.initials: M
authors.lastname: Aviles
authors.forename: L P
authors.initials: LP
authors.lastname: Brion
mesh_terms: D001942:Breast Feeding / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D006282:Health Personnel; D006801:Humans; D017145:Models, Educational; D009774:Obstetrics; D010353:Patient Education as Topic; D018743:Perinatal Care; D011204:Poverty Areas; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors