title: The impact of mother-to-mother support on optimal breast-feeding: a controlled community intervention trial in peri-urban Guatemala City, Guatemala.
abstract: OBJECTIVE
  To assess the impact that a mother-to-mother support program operated by La Leche League Guatemala had on early initiation of breast-feeding and on exclusive breast-feeding in peri-urban Guatemala City, Guatemala.
  
  
  METHODS
  A population census was conducted to identify all mothers of infants < 6 months of age, and the mothers were then surveyed on their breast-feeding practices, in two program communities and two control communities. Data collection for this follow-up census and survey was carried out between November 2000 and January 2001, one year after a baseline census and survey had been conducted.
  
  
  RESULTS
  At follow-up, 31% of mothers in the program communities indicated that counselors had advised them about breast-feeding, 21% said they had received a home visit, and 16% reported attending a support group. Community wide rates of early initiation of breast-feeding were significantly higher in program areas than in the control communities, at both baseline and follow-up. However, the change over time in early initiation in program communities was not significantly different from the change in control communities. Community wide rates of exclusive breast-feeding were similar in program and control sites and did not change significantly from baseline to follow-up. However, of the mothers in the program communities who both received home visits and attended support groups, 45% of them exclusively breast-fed, compared to 14% of women in program communities who did not participate in those two activities. In addition, women who were exposed to mother-to-mother support activities during the year following the baseline census and survey were more likely than mothers exposed before that period to exclusively breast-feed. This suggests that the program interventions became more effective over time.
  
  
  CONCLUSIONS
  This study does not provide evidence of population impact of La Leche League's intervention after one year of implementation. In peri-urban Guatemala, long-term community-based interventions, in partnership with existing health care systems, may be needed to improve community wide exclusive breast-feeding rates.
authors.affiliation: Brigham Young University, Department of Health Science, Provo, Utah, USA. kirk_dearden@byu.edu
authors.forename: Kirk
authors.initials: K
authors.lastname: Dearden
authors.forename: Mekibib
authors.initials: M
authors.lastname: Altaye
authors.forename: Irma
authors.initials: I
authors.lastname: De Maza
authors.forename: Maritza
authors.initials: M
authors.lastname: De Oliva
authors.forename: Maryanne
authors.initials: M
authors.lastname: Stone-Jimenez
authors.forename: Barton R
authors.initials: BR
authors.lastname: Burkhalter
authors.forename: Ardythe L
authors.initials: AL
authors.lastname: Morrow
mesh_terms: D000328:Adult; D001942:Breast Feeding; D003625:Data Collection; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D006166:Guatemala; D006266:Health Education; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D012944:Social Support; D013997:Time Factors