Breastfeeding Counseling for Low-Income Latino Population

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Article Citation

Chapman, D. J., Damio, G., Young, S., & Pérez-Escamilla, R. (2004). Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 158(9), 897-902.

PICOT Question

Among young, low-income, predominantly Latina pregnant women who consider breastfeeding, will routine breastfeeding education plus peer counseling, compared to routine breastfeeding education only, improve the breastfeeding initiation rate and the breastfeeding rate at one and three months postpartum, if the intervention is conducted during pregnancy (daily visits) and after it (one, three, and six months postpartum)?

Purpose of the Study

The purpose of the study was to evaluate the effectiveness of the breastfeeding peer counseling program that is currently used in the United States for improving breastfeeding rates among low-income young women from a predominantly Latina population.

Research Questions

Will an existing breastfeeding peer counseling program (in addition to the currently implemented routine prenatal education on breastfeeding) raise the breastfeeding initiation rate? Will it raise the breastfeeding rates during the first three months postpartum?

Hypotheses

The authors’ major hypothesis was that a breastfeeding peer counseling program, which consists of both home- and hospital-based services, would improve the breastfeeding rates among targets of the research. It was also expected that, due to the support from women who had successful breastfeeding experience, the breastfeeding rates in the intervention group would be remarkably higher than in the control group.

Aims of the Study

The study was aimed at providing the intervention to women randomly selected from the sample (the rest of the sample was assigned to be the control group) and measuring the results both during pregnancy and postpartum.

Study Design

The study is a randomized controlled trial in which the participants were recruited by research assistants who would not be the participants’ peer counselors. The design was approved by both the researchers’ institution and the health care facility.

Sample

In the study, 165 women participated; 90 in the intervention group, and 75 in the control group. Inclusion criteria included being pregnant (less than or equal to 26 weeks’ gestation), having low income, considering breastfeeding, and having access to a telephone for contacts as needed.

Variables

The independent variable was the breastfeeding peer counseling program, i.e. the intervention provided as part of the study. The dependent variables were various breastfeeding rates, including breastfeeding initiation (breastfeeding status at birth) and successful breastfeeding within the first three months postpartum.

Statistical Analysis

Various participant characteristics were considered in the analysis of data apart from income, including, origin, education, marital status, previous breastfeeding experiences, and others. The use of statistical tools allowed considering and ruling out the null hypothesis, i.e. the assumption that there were no correlations between independent and dependent variables.

Validity of Results

The validity of results can be evaluated from two perspectives: study design and data analysis. The design, including sampling, random distribution into groups, and performing baseline measurements, made the study generalizable and replicable. Data analysis with the use of appropriate statistical tools allowed regarding the quantitative results as reliable.

Results of the study

In the intervention group, only nine percent did not initiate breastfeeding, while in the control group, this rate was 23 percent. Also, the members of the control group were more likely to stop breastfeeding both within the first-month postpartum (49 percent) and during the next two months (71 percent).

Implications

These results can help me in caring for patients and families because the study confirms that the use of the breastfeeding peer counseling program is effective in terms of improving breastfeeding rates. Studying this program and applying it to my practice and the provision of prenatal education will help me improve patient outcomes in terms of encouraging young women to breastfeed.

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