title: Prioritization of resources for participants in a peer counseling breastfeeding support program.
abstract: BACKGROUND
  Peer counseling (PC) breastfeeding support programs have proven effective in increasing breastfeeding duration in low-income women.
  
  
  OBJECTIVE
  This study aimed to describe program participants and breastfeeding duration in a PC program according to (1) timing of enrollment (prenatal vs postnatal) and (2) breastfeeding status at program exit (discontinued breastfeeding, exited program while breastfeeding, and completed 1 year program) to improve understanding of how these groups differ and how services might be optimized when resources are limited.
  
  
  METHODS
  This study is a secondary analysis of data from low-income women enrolled in a PC breastfeeding support program. Participant characteristics and breastfeeding duration were described using chi-square tests, analyses of variance, and logistic regression.
  
  
  RESULTS
  Postnatal enrollees had longer breastfeeding duration than prenatal enrollees (F < .001) and were more likely to be older, to be married, to be more educated, and to have prior breastfeeding experience (each variable P < .01). Women who withdrew from the program while breastfeeding were more demographically similar to those who discontinued breastfeeding prior to 1 year than to those who continued in the program breastfeeding for 1 year, although they breastfed for significantly longer at exit (mean ± SD = 27.8 ± 14.8 weeks) compared to women who discontinued breastfeeding while in the program (15.7 ± 13.3 weeks) (P < .001).
  
  
  CONCLUSIONS
  It may be advantageous for peer counselors to direct fewer resources to later postnatal enrollees and more to prenatal or early postnatal enrollees. It may also be advantageous to focus on supporting women at high risk of discontinuation rather than on retaining women who choose to withdraw from the program while breastfeeding.
authors.affiliation: Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
authors.forename: Mary R
authors.initials: MR
authors.lastname: Rozga
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Kerver
authors.affiliation: Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA bholson@wisc.edu.
authors.forename: Beth H
authors.initials: BH
authors.lastname: Olson
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data*; D000072117:Counselors; D005006:Ethnicity; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services / Q000191:economics*; D008824:Michigan; D010379:Peer Group; D015397:Program Evaluation; D040841:Resource Allocation; D012923:Social Class; D012944:Social Support; D055815:Young Adult
keywords: breastfeeding; breastfeeding duration; low-income; peer counseling