title: Evaluation of the Missouri WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) breast-feeding peer counselling programme.
abstract: OBJECTIVE
  To evaluate the effectiveness of the peer counselling (PC) programme on breast-feeding initiation among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Missouri, and to identify factors that facilitate breast-feeding initiation.
  
  
  METHODS
  We used the data from the 2006 Missouri Pregnancy Nutrition Surveillance System, Missouri Live Birth Records and the Missouri WIC programme to compare breast-feeding initiation rates between PC and non-PC agencies. We used multilevel logistic regression, with individual participants being nested within agencies, to control for individual- and agency-level characteristics.
  
  
  RESULTS
  The breast-feeding initiation rate in PC agencies was significantly higher than in non-PC agencies among prenatal participants, but the difference was not significant among postpartum participants. After controlling for maternal sociodemographic characteristics, compared with prenatal cases in non-PC agencies, prenatal cases in PC agencies were more likely to initiate breast-feeding (OR = 1.21; 95 % CI 1.03, 1.43), whereas postpartum cases were less likely to initiate breast-feeding. Among prenatal participants in PC agencies, longer duration of prenatal WIC enrolment was associated with a higher rate of breast-feeding initiation. After adjusting for maternal sociodemographic characteristics and other agency-level characteristics, participants of PC agencies with an international board-certified lactation consultant were more likely to initiate breast-feeding than participants of PC agencies without such a consultant (OR = 1.21; 95 % CI 1.01, 1.45).
  
  
  CONCLUSIONS
  Prenatal participation in the WIC breast-feeding PC programme (especially participation early during pregnancy) was associated with an increased rate of breast-feeding initiation in Missouri.
authors.affiliation: Division of Community and Public Health, Missouri Department of Health and Senior Services, Jefferson City, MO, USA. shumei.yun@doh.wa.gov
authors.forename: Shumei
authors.initials: S
authors.lastname: Yun
authors.forename: Qian
authors.initials: Q
authors.lastname: Liu
authors.forename: Kathy
authors.initials: K
authors.lastname: Mertzlufft
authors.forename: Catherine
authors.initials: C
authors.lastname: Kruse
authors.forename: Maggie
authors.initials: M
authors.lastname: White
authors.forename: Phyllis
authors.initials: P
authors.lastname: Fuller
authors.forename: Bao-Ping
authors.initials: BP
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000453:epidemiology / Q000523:psychology / Q000706:statistics & numerical data*; D003376:Counseling; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008923:Missouri; D016017:Odds Ratio; D010379:Peer Group; D011159:Population Surveillance; D011295:Prenatal Care; D015397:Program Evaluation; D011632:Public Assistance; D055815:Young Adult