A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community.
OBJECTIVE
To assess the efficacy of peer counseling to promote exclusive breastfeeding (EBF) among low-income inner-city women in Hartford, Conn.


METHODS
Participants recruited prenatally were randomly assigned to either receive support for EBF from a peer counselor plus conventional breastfeeding support (peer counseling group [PC]) or only conventional breastfeeding support (control group [CG]) and followed through 3 months post partum.


METHODS
Low-income predominantly Latina community.


METHODS
Expectant mothers, less than 32 weeks gestation and considering breastfeeding (N = 162). Intervention Exclusive breastfeeding peer counseling support offering 3 prenatal home visits, daily perinatal visits, 9 postpartum home visits, and telephone counseling as needed.


METHODS
Exclusive breastfeeding rates at hospital discharge, 1, 2, and 3 months post partum (n = 135).


RESULTS
At hospital discharge, 24% in the CG compared with 9% in the PC had not initiated breastfeeding, with 56% and 41%, respectively, nonexclusively breastfeeding. At 3 months, 97% in the CG and 73% in the PC had not exclusively breastfed (relative risk [RR] = 1.33; 95% CI, 1.14-1.56) during the previous 24 hours. The likelihood of nonexclusive breastfeeding throughout the first 3 months was significantly higher for the CG than the PC (99% vs 79%; RR = 1.24; 95% CI, 1.09-1.41). Mothers in the CG were less likely than their PC counterparts to remain amenorrheic at 3 months (33% vs 52%; RR = 0.64; 95% CI, 0.43-0.95). The likelihood of having 1 or more diarrheal episode in infants was cut in half in the PC (18% vs 38%; RR = 2.15; 95% CI, 1.16-3.97).


CONCLUSIONS
Well-structured, intensive breastfeeding support provided by hospital and community-based peer counselors is effective in improving exclusive breastfeeding rates among low-income, inner-city women in the United States.
Anderson
Alex K
AK
Department of Nutritional Sciences, University of Connecticut, Storrs, CT, USA. anderson@fcs.uga.edu
Damio
Grace
G
Young
Sara
S
Chapman
Donna J
DJ
Pérez-Escamilla
Rafael
R
D000328:Adult; D001942:Breast Feeding / Q000208:ethnology*; D003153:Community Health Services / Q000458:organization & administration*; D003237:Connecticut; D003376:Counseling; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D010379:Peer Group; D011203:Poverty / Q000208:ethnology*; D011247:Pregnancy; D011295:Prenatal Care / Q000458:organization & administration*; D016730:Program Development; D012944:Social Support; D012959:Socioeconomic Factors