title: Early postpartum: a critical period in setting the path for breastfeeding success.
abstract: BACKGROUND
  In the United States, most mothers who initiate breastfeeding will either stop or begin supplementing with formula before their infants are 3 months old. Routine breastfeeding education and support following hospital discharge are critical to breastfeeding success. The purpose of this article is to identify this critical period for supporting and reinforcing breastfeeding.
  
  
  METHODS
  We will use data from participants enrolled in the Maryland State Program of the U.S. Department of Agriculture's Supplemental Nutrition Program for Women, Infants, and Children (WIC). This cross-sectional study will explore whether breastfeeding patterns during the period between birth and postnatal WIC certification differ by participation in a local WIC agency that provides breastfeeding peer counselor support (PC) versus two comparison groups, the lactation consultant (LC) and standard care (SC) groups.
  
  
  RESULTS
  During 2007, 33,582 infants were enrolled in the Maryland State WIC program. Infant breastfeeding status was categorized as exclusively breastfeeding, partially breastfeeding, or not breastfeeding. At certification, 30.4% of infants were breastfeeding, 25.3% had been breastfed but had stopped before certification in WIC, and 44.3% never breastfed. The breastfeeding initiation rate was higher for the PC group compared with the LC and SC groups (61.6% vs. 54.4% and 47.6%, respectively; p < 0.001). Participants in the PC group were more likely to certify as exclusively and partially breastfeeding compared with the LC and SC groups (36.0% vs. 24.8% and 25.3%, respectively; p < 0.001).
  
  
  CONCLUSIONS
  Our analysis identifies a window of opportunity during which targeted contact with breastfeeding mothers could enhance longer-term breastfeeding rates.
authors: Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, The Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA. sgross@jhsph.edu
authors: Susan M
authors: SM
authors: Gross
authors: Amy K
authors: AK
authors: Resnik
authors: Joy P
authors: JP
authors: Nanda
authors: Caitlin
authors: C
authors: Cross-Barnet
authors: Marycatherine
authors: M
authors: Augustyn
authors: Linda
authors: L
authors: Kelly
authors: David M
authors: DM
authors: Paige
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology; D003423:Critical Period, Psychological; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008396:Maryland / Q000453:epidemiology; D008425:Maternal Behavior; D008427:Maternal Health Services / Q000458:organization & administration*; D009035:Mothers / Q000193:education; D049590:Postpartum Period; D011247:Pregnancy; D012959:Socioeconomic Factors