Peers boost breastfeeding among low-income women

Low-income women may be more likely to breastfeed their infants if they get a little encouragement from their peers, according to new study findings.

Researchers found that a peer-counseling program boosted rates of exclusive breastfeeding among low-income, predominantly Hispanic women who gave birth at one urban hospital. Compared with new mothers not involved in the program, these women were 15 times more likely to give their infants only breast milk for the first 3 months of life.

About 20 percent of women who received peer counseling exclusively breastfed for 3 months, versus just over 1 percent of other mothers, according to findings published in the September issue of the Archives of Pediatrics & Adolescent Medicine.

Breast milk is considered the best nutrition for infants, with studies documenting numerous benefits, including lower risks of Diarrhea, ear and respiratory infections, and allergies. Experts generally recommend that babies receive only breast milk for the first 6 months of life.

Even though breastfeeding is on the rise in the U.S., rates remain especially low among low-income families.

And although the majority of women in this study were not exclusively breast feeding after 3 months, the 20-percent rate is still encouraging, said lead study author Dr. Alex K. Anderson.

Anderson, who is now at the University of Georgia, Athens, was with the University of Connecticut at the time of the study.

The researchers followed 162 expectant mothers who were giving birth at Hartford Hospital, about half of whom they randomly assigned to receive peer counseling.

Successful breastfeeding depends in part on the mother’s confidence in her ability to breastfeed. This involves having the proper environment to nurse and being prepared emotionally and physically for the experience. If the mother is pain free, relaxed and supported by family and others, success is more likely. Proper nipple care, positioning and nursing frequency may help to prevent some common breastfeeding problems.

Two women recruited from the community, who themselves had exclusively breastfed their babies, served as the peer counselors. They were trained by a certified lactation consultant to teach other women about the benefits of breastfeeding and how to successfully do it.

Women in the peer-counseling group were offered home visits from their counselor, starting before delivery. Those in the comparison group received the standard breastfeeding encouragement given at the hospital, which is designated as a “Baby-Friendly” center. This means the hospital has particular policies that actively encourage breastfeeding - such as rooming mothers and infants together 24 hours a day and not giving parents free formula and bottles.

Because of this, the number of women who began breastfeeding in the hospital - even in the control group - was higher than the norm for the U.S., according to Anderson. Ninety-one percent of women in the peer-counseling group started breast feeding during their hospital stay, as did 76 percent of those in the comparison group.

It will be important, Anderson noted, to see whether peer counseling works at hospitals that are not designated as Baby-Friendly, which describes the vast majority of U.S. centers.

There are, however, many other factors that affect a mother’s ability to exclusively breastfeed, Anderson said. These include the length of maternity leave and whether the job environment allows a mother to pump her breast milk. He also pointed to a need for public policies that encourage exclusive breastfeeding, and not just any breastfeeding, as well as broader acceptance of breastfeeding in public areas.

SOURCE: Archives of Pediatrics & Adolescent Medicine, September 2005.

Provided by ArmMed Media
Revision date: July 4, 2011
Last revised: by Sebastian Scheller, MD, ScD