Lactation consultant visits spur breastfeeding among women who usually resist it

In two separate clinical trials, researchers at Albert Einstein College of Medicine of Yeshiva University have found that periodic meetings with a lactation consultant encourages women traditionally resistant to breastfeeding to do so, at least for a few months- long enough for mother and child to gain health benefits. The results of the trials were published online today in American Journal of Public Health.

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months after birth, followed by continued breastfeeding for one year or longer as other foods are introduced. However, according to the Centers for Disease Control and Prevention (CDC), fewer than 75 percent of infants nationwide are breastfed at all and fewer than half are still being breastfed at six months. Health benefits of breastfeeding can include reduced incidence of ear infections, stomach illness and lower obesity rates for children and, for mothers, a reduced risk for pre-menopausal breast cancer, type 2 diabetes and heart disease.

In one of the two trials included in this paper, women who were regularly encouraged and given instruction and support for breastfeeding were more than four times as likely to exclusively breastfeed their infant at one month and nearly three times more likely to do so at three months, compared with the control group.

"The effects of the interventions in our trials - and our use of lactation consultants in particular - were more impressive than those reported by two recent reviews that evaluated the effects of the numerous previous trials aimed at improving breastfeeding rates," said Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein.

Some of the lowest rates of breastfeeding are known to occur among Black/non-Hispanic, younger, overweight and less-educated mothers - together those women made up a large majority of those enrolled in the two trials. Patients included in the trials received their care at Montefiore Medical Center, Einstein's University Hospital.

Both clinical trials tested the same interventions for effectiveness in encouraging women to breastfeed: (1) support from a lactation consultant (LC) consisting of two prenatal sessions and one post-birth hospital session, plus regular phone calls post-partum for three months or until breastfeeding ceased; and (2) use of electronic prompts (EP) to remind physicians and midwives to discuss breastfeeding with the women during five prenatal visits.

"Two-thirds of the women in the trials were either overweight or obese, which means they're not inclined to breast feed," said Dr. Bonuck. "There are physical difficulties with the baby latching on, many of these women have difficulty producing enough milk, and there may be psychological barriers as well. Yet we showed that support from a lactation consultant significantly improves their chances of breastfeeding for three months - sufficient time for mother and baby to obtain important health benefits."