title: Breastfeeding education and support trial for overweight and obese women: a randomized trial.
abstract: OBJECTIVE
  To evaluate a specialized breastfeeding peer counseling (SBFPC) intervention promoting exclusive breastfeeding (EBF) among overweight/obese, low-income women.
  
  
  METHODS
  We recruited 206 pregnant, overweight/obese, low-income women and randomly assigned them to receive SBFPC or standard care (controls) at a Baby-Friendly hospital. SBFPC included 3 prenatal visits, daily in-hospital support, and up to 11 postpartum home visits promoting EBF and addressing potential obesity-related breastfeeding barriers. Standard care involved routine access to breastfeeding support from hospital personnel, including staff peer counselors. Data collection included an in-hospital interview, medical record review, and monthly telephone calls through 6 months postpartum to assess infant feeding practices, demographics, and health outcomes. Bivariate and logistic regression analyses were conducted.
  
  
  RESULTS
  The intervention had no impact on EBF or breastfeeding continuation at 1, 3, or 6 months postpartum. In adjusted posthoc analyses, at 2 weeks postpartum the intervention group had significantly greater odds of continuing any breastfeeding (adjusted odds ratio [aOR]: 3.76 [95% confidence interval (CI): 1.07-13.22]), and giving at least 50% of feedings as breast milk (aOR: 4.47 [95% CI: 1.38-14.5]), compared with controls. Infants in the intervention group had significantly lower odds of hospitalization during the first 6 months after birth (aOR: 0.24 [95% CI: 0.07-0.86]).
  
  
  CONCLUSIONS
  In a Baby-Friendly hospital setting, SBFPC targeting overweight/obese women did not impact EBF practices but was associated with increased rates of any breastfeeding and breastfeeding intensity at 2 weeks postpartum and decreased rates of infant hospitalization in the first 6 months after birth.
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut 06510, USA. donna.chapman@yale.edu
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Chapman
authors.forename: Katherine
authors.initials: K
authors.lastname: Morel
authors.forename: Angela
authors.initials: A
authors.lastname: Bermúdez-Millán
authors.forename: Sara
authors.initials: S
authors.lastname: Young
authors.forename: Grace
authors.initials: G
authors.lastname: Damio
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000208:ethnology* / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009765:Obesity / Q000208:ethnology* / Q000628:therapy; D050177:Overweight / Q000208:ethnology* / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods* / Q000639:trends; D011181:Postnatal Care / Q000379:methods* / Q000639:trends; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods / Q000639:trends; D055815:Young Adult