title: Impact of peer counselors on breastfeeding outcomes in a nondelivery NICU setting.
abstract: OBJECTIVE
  Although the independent effects of lactation consultants and peer counselors have been shown to improve breastfeeding outcomes, the joint effects have yet to be considered, particularly in the neonatal intensive care unit (NICU) in nondelivery hospitals. Therefore, the objective of this study was to assess the effect of lactation staff type on breastfeeding outcomes during hospital stay after the addition of peer counselors to a NICU lactation program.
  
  
  METHODS
  A total of 596 mother-infant pairs admitted to Nationwide Children's Hospital, Columbus, Ohio, pre- and postlactation program expansion.
  
  
  METHODS
  A descriptive pre-/posttest study as conducted.
  
  
  METHODS
  Differences in provision of any maternal breast milk, exclusive breast milk, or direct breastfeeding during NICU stay and at discharge were evaluated pre and postprogram implementation. Logistic regression was used to determine associations between lactation staff type and each outcome during hospital stay.
  
  
  RESULTS
  Infants receiving any breast milk during NICU stay increased from baseline to postprogram year 1 (63% vs 73%; P= 0.03). Direct breastfeeding increased from baseline to postprogram year 4 (42% vs 53%; P= 0.03). Mothers seen by only peer counselors were less likely to provide any breast milk at discharge, provide exclusive breast milk during stay or discharge, to be direct breastfeeding during stay or at discharge compared with mothers seen by both peer counselors and lactation consultants.
  
  
  CONCLUSIONS
  NICU lactation programs should consider including both peer counselors and lactation consultants to improve breastfeeding outcomes during hospital stay.
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio (Drs Oza-Frank and Ms Smith); Department of Pediatrics, The Ohio State University, Columbus (Dr Oza-Frank); and Northeast Ohio Medical University, Rootstown (Ms Bhatia).
authors.forename: Reena
authors.initials: R
authors.lastname: Oza-Frank
authors.forename: Anisha
authors.initials: A
authors.lastname: Bhatia
authors.forename: Christine
authors.initials: C
authors.lastname: Smith
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D061186:Breast Milk Expression / Q000706:statistics & numerical data; D015331:Cohort Studies; D003253:Consultants; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D009035:Mothers; D010379:Peer Group; D055815:Young Adult