title: Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: a randomized controlled trial.
abstract: BACKGROUND
  Breastfeeding peer counseling has improved breastfeeding rates in developing countries; however, its impact in this country has not been adequately evaluated.
  
  
  OBJECTIVE
  To evaluate the effectiveness of an existing, breastfeeding peer counseling program within the United States.
  
  
  METHODS
  Randomized, prospective, controlled trial in which participants were recruited prenatally and randomly assigned to receive either routine breastfeeding education or routine breastfeeding education plus peer counseling.
  
  
  METHODS
  An urban hospital serving a large population of low-income Latinas.
  
  
  METHODS
  Pregnant women (< or =26 weeks' gestation) were recruited from the hospital's prenatal clinic. Inclusion criteria specified that participants be low income, be considering breastfeeding, have delivered a healthy, full-term singleton, and have access to a telephone. Intervention Breastfeeding peer counseling services included 1 prenatal home visit, daily perinatal visits, 3 postpartum home visits, and telephone contact as needed.
  
  
  METHODS
  Breastfeeding rates at birth and 1, 3, and 6 months postpartum.
  
  
  RESULTS
  The proportion not initiating breastfeeding was significantly lower in the intervention group than among controls (8/90 [9%] vs 17/75 [23%]; relative risk, 0.39; 95% confidence interval, 0.18-0.86). The probability of stopping breastfeeding also tended to be lower in the intervention group at both 1 month (36% vs 49%; relative risk, 0.72; 95% confidence interval, 0.50-1.05) and 3 months (56% vs 71%; relative risk, 0.78; 95% confidence interval, 0.61-1.00).
  
  
  CONCLUSIONS
  These findings demonstrate that, in the United States, peer counselors can significantly improve breastfeeding initiation rates and have an impact on breastfeeding rates at 1 and 3 months post partum.
authors.affiliation: Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269-4017, USA. djc@discovernet.net
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Chapman
authors.forename: Grace
authors.initials: G
authors.lastname: Damio
authors.forename: Sara
authors.initials: S
authors.lastname: Young
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000208:ethnology*; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006293:Health Promotion; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D008429:Maternal Welfare; D010379:Peer Group; D011203:Poverty / Q000208:ethnology*; D015397:Program Evaluation; D011446:Prospective Studies; D013223:Statistics as Topic; D014481:United States / Q000208:ethnology