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Ouyang YQ, Guo J, Zhou J, Zhouchen Y, Huang C, Huang Y, Wang R, Redding SR. Theoretical approaches in the development of interventions to promote breastfeeding: A scoping review. Midwifery 2024; 132:103988. [PMID: 38583270 DOI: 10.1016/j.midw.2024.103988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
PROBLEM AND BACKGROUND There is a low world rate of exclusive breastfeeding and a short duration of breastfeeding. More studies have constructed interventions to improve breastfeeding behavior, but the actual effect is not significant. AIM The purpose of this review is identifying the ways that various theories have an influence on theory-based breastfeeding intervention studies. METHODS A scoping review using Arksey and O'Malley's framework explored breastfeeding promotion practices. PubMed, The Cochrane Library, Web of Science, Embase, and CINAHL databases were searched from database creation to March 9, 2024. Building on previous research, key terms were used to search the literature. Data analysis involved descriptive and interpretive summaries of theories used and the proposed interventions. FINDINGS An online search yielded 906 articles, with 28 meeting the inclusion criteria for the scoping review, including 5 reviews and 23 articles. Reviews demonstrated that interventions based on theories were more effective. Articles promoting breastfeeding used theories of self-efficacy (n = 9), theory of planned behavior (n = 8), social cognitive theory (n = 5) and individual and family self-management theory (n = 1). These theories were used in developing specific content of the intervention program (n = 20, 86.9%), constructing the framework of the program (n = 10, 43.5%), and evaluating outcomes (n = 19, 82.6%). Most interventions focused on education, professional support, and/or peer support for breastfeeding. CONCLUSION AND DISCUSSION Theory can guide decisions and play a role in selecting a methodology or lens. Researchers should make deliberate choices in the use of a theory that relates to aspects of breastfeeding behavior. Future interventions based on theories should be more varied and effective and need to consider families' and social factors.
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Affiliation(s)
| | - Jinyi Guo
- School of Nursing, Wuhan University, Wuhan, China.
| | - Jie Zhou
- School of Nursing, Wuhan University, Wuhan, China.
| | | | - Canran Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Yiyan Huang
- School of Nursing, Wuhan University, Wuhan, China
| | - Rong Wang
- Renmin Hospital of Wuhan University, Wuhan, China
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Keenan-Devlin LS, Smart BP, Hirschhorn L, Meier P, Jefferson U, Solomonides A, Wang CE, Handler A, Silver RK, Borders AEB. Clinically Integrated Breastfeeding Peer Counseling to Promote Breastfeeding Equity. Am J Perinatol 2024; 41:e2313-e2325. [PMID: 37494586 DOI: 10.1055/s-0043-1771255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This study aimed to determine whether clinically integrated Breastfeeding Peer Counseling (ci-BPC) added to usual lactation care reduces disparities in breastfeeding intensity and duration for Black and Hispanic/Latine participants. STUDY DESIGN This study is a pragmatic, randomized control trial (RCT) of ci-BPC care at two ci-BPC-naïve obstetrical hospital facilities in the greater Chicago area. Participants will include 720 patients delivering at Hospital Site 1 and Hospital Site 2 who will be recruited from eight prenatal care sites during midpregnancy. Participants must be English or Spanish speaking, planning to parent their child, and have no exposure to ci-BPC care prior to enrollment. Randomization will be stratified by race and ethnicity to create three analytic groups: Black, Hispanic/Latine, and other races. RESULTS The primary outcome will be breastfeeding duration. Additional outcomes will include the proportion of breastmilk feeds during the delivery admission, at 6-week postdelivery, and at 6-month postdelivery. A process evaluation will be conducted to understand implementation outcomes, facilitators, and barriers to inform replication and scaling of the innovative ci-BPC model. CONCLUSION This research will produce findings of relevance to perinatal patients and their families, the vast majority of whom desire to provide breastmilk to their infants and require support to succeed with their feeding goals. As the largest RCT of ci-BPC in the United States to date, this research will improve the quality of evidence available regarding the effectiveness of ci-BPC at reducing disparities. These findings will help patients and stakeholders determine the benefits of accepting and adopting the program and inform policies focused on improving perinatal care and reducing maternal/child health disparities. This study is registered with Clinical Trial (identifier: NCT05441709). KEY POINTS · Ci-BPC can promote racial breastfeeding equity.. · Ci-BPC has not been tested as a generalized lactation strategy in prior trials and is underused.. · This RCT will identify if ci-BPC can reduce breastfeeding disparities for Black and Hispanic patients..
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Affiliation(s)
- Lauren S Keenan-Devlin
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Britney P Smart
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
| | - Lisa Hirschhorn
- Medical and Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paula Meier
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, Illinois
| | - Urmeka Jefferson
- Department of Women, Children and Family Nursing, Rush University College of Nursing, Chicago, Illinois
| | | | - Chi Ed Wang
- Research Institute, NorthShore University HealthSystem, Evanston, Illinois
| | - Arden Handler
- Community and Health Sciences, University of Illinois Chicago School of Public Health, Chicago, Illinois
| | - Richard K Silver
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Ann E B Borders
- Department of Obstetrics and Gynecology NorthShore University HealthSystem, Evanston, Illinois
- Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
- Institute for Public Health and Medicine, Northwestern University Center for Healthcare Studies, Chicago, Illinois
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Fan HSL, Ho MY, Ko RWT, Kwok JYY, Chau PH, Wong JYH, Wang MP, Lok KYW. Feasibility and effectiveness of WhatsApp online group on breastfeeding by peer counsellors: a single-blinded, open-label pilot randomized controlled study. Int Breastfeed J 2022; 17:91. [PMID: 36544208 PMCID: PMC9771777 DOI: 10.1186/s13006-022-00535-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION With mobile technologies becoming more advanced and accessible, mobile health (mHealth) has been incorporated in delivering timely and convenient breastfeeding support. However, its feasibility and potential efficacy remain to be examined. Therefore, the primary objective of this study is to assess the feasibility and acceptability of an online instant messaging peer support group for breastfeeding. The secondary objective is to evaluate the effect of the intervention on breastfeeding outcomes. METHODS A pilot randomized controlled trial was conducted. A total of 33 primiparous women were recruited in the antenatal clinic at a public hospital in Hong Kong between March and April 2021. They were randomized to receive either standard care (n = 18) or standard care and receive peer-group support in an online instant messaging app (n = 15). Participants received telephone follow-up for up to six months postpartum or until they stopped breastfeeding. After completing the study, six participants in the intervention group were interviewed to understand their perceptions of the intervention. RESULTS This pilot study shows that online messaging peer support group is feasible and acceptable to women. In total, 54.4% of the eligible women agreed to participate, and 97.0% completed the follow-up. Participants perceived that providing peer support through instant messaging app is appropriate. It serves as a channel for the participants to ask questions and obtain information. Furthermore, meetings of the peer supporters and group members can be held to enhance the effectiveness of the intervention. In addition, no significant differences were found in any and exclusive breastfeeding rates, breastfeeding attitude, and breastfeeding self-efficacy between the two groups. CONCLUSIONS This study shows that online messaging peer support group is feasible and acceptable. A full-scale study should be conducted to understand the effect of the online instant messaging peer support group on breastfeeding outcomes. TRIAL REGISTRATION The study protocol is registered on Clinicaltrial.gov (NCT04826796) on 1 April 2021.
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Affiliation(s)
- Heidi S. L. Fan
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. Y. Ho
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Rachel W. T. Ko
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Jojo Y. Y. Kwok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - P. H. Chau
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Janet Y. H. Wong
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - M. P. Wang
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Kris Y. W. Lok
- grid.194645.b0000000121742757School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
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Marshall NA, Cook CS. Trust Black Women: Using Photovoice to Amplify the Voices of Black Women to Identify and Address Barriers to Breastfeeding in Southeast Georgia. Health Promot Pract 2022; 24:128S-139S. [PMID: 36419257 DOI: 10.1177/15248399221135102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This article is temporarily under embargo.
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Kelly KJ, Doucet S, Luke A, Azar R, Montelpare W. Experiences, Motivations, and Perceived Impact of Participation in a Facebook-Based Support Group for Caregivers of Children and Youth With Complex Care Needs: Qualitative Descriptive Study. JMIR Pediatr Parent 2022; 5:e33172. [PMID: 35793139 PMCID: PMC9301556 DOI: 10.2196/33172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 05/03/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Caregivers of children and youth with complex care needs (CCNs) often require considerable support to ensure the well-being of their families. Social media present an opportunity to better support caregivers through computer-mediated communication for social support. Peer-to-peer (P2P) support groups are a way in which caregivers are accessing needed support; however, the experiences of caregivers who use these groups and the perceived impact that participation has on caregivers of children and youth with CCNs are not known. OBJECTIVE This study aimed to explore the experiences of caregivers of children and youth with CCNs who use a Facebook-based P2P support group to communicate, understand their motivations to use the group, and investigate its perceived impact on knowledge of programs and services and sense of community belonging among caregivers. METHODS A qualitative descriptive design was used to explore the experiences and perceived impact of a Facebook-based (Meta Platforms) P2P support group for caregivers of children and youth with CCNs in New Brunswick, Canada. The group was launched on the web in October 2020, during the COVID-19 pandemic, and resulted in 108 caregivers joining the group. A web-based survey was distributed, and semistructured interviews were conducted in February 2021 with a subsample of members. Thematic analysis was used to identify and report patterns related to caregivers' experiences and perceived impacts of participation. RESULTS A subsample of members in the Facebook group completed the web-based survey (39/108, 36.1%) and interviews (14/108, 12.9%). A total of 5 themes emerged from the interviews: safe space, informational support and direction, web-based connection with peers, impact on knowledge of programs and services, and degree of community belonging. Participants reported joining the group to obtain geography-specific information support and connect with peers. Many participants reported an improvement in their knowledge of programs and services and felt connected to the community; however, the short observation period and diversity among the caregiver population were cited as barriers to community belonging. CONCLUSIONS Social media present an important opportunity to facilitate the exchange of support between patients and caregivers in an accessible and curated environment. Findings from this study suggest that involvement in web-based, geography-specific P2P support groups can influence perceived knowledge of services and resources and sense of community belonging among caregivers of children and youth with CCNs. Furthermore, this study provides insight into the experiences and motivations of caregivers of children and youth with CCNs who participate in a private social media environment.
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Affiliation(s)
- Katherine Jennifer Kelly
- Health Centred Research Clinic, Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Shelley Doucet
- Centre for Research in Integrated Care, Department of Nursing and Health Sciences, University of New Brunswick Saint John, Saint John, NB, Canada
| | - Alison Luke
- Centre for Research in Integrated Care, Department of Nursing and Health Sciences, University of New Brunswick Saint John, Saint John, NB, Canada
| | - Rima Azar
- Psychobiology of Stress & Health Lab, Department of Psychology, Mount Alison University, Sackville, NB, Canada
| | - William Montelpare
- Health Centred Research Clinic, Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
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Kirksey K. A social history of racial disparities in breastfeeding in the United States. Soc Sci Med 2021; 289:114365. [PMID: 34592542 DOI: 10.1016/j.socscimed.2021.114365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 08/22/2021] [Accepted: 09/01/2021] [Indexed: 11/15/2022]
Abstract
Over the past five decades in the United States, White women have breastfed at higher rates than Black women. While a small but growing body of social historical research has examined racial disparities in breastfeeding over time, empirical research, particularly quantitative research, has focused on single historical snapshots, unintentionally treating the persistent racial disparities in breastfeeding as a static phenomenon, rather than one with distinct social mechanisms at different points in time. Further, few studies on racial disparities in health deconstruct difference both within and across racial groups. But what if we thought about persistent racial disparities instead as discrete trends with distinct social mechanisms at different points in time? In a binary logistic regression of breastfeeding initiation rates from 1973 to 2015 using the National Survey of Family Growth (NSFG), I found that the persistent racial disparities were actually comprised of three distinct types of changing racial disparities: (1) increases in racial disparities that derive from improvements for Whites not captured by Blacks (1973-1982); (2) decreases in racial disparities that stem from improvements for Whites captured even more strongly by Blacks (1995-2006); and, (3) leveling off of racial disparities (2006-2015). Placing results of this quantitative analysis within the context of public policy and social movement history, I identify three distinct mechanisms that drive the different trends in racial disparities in breastfeeding. This paper contributes to the literature on motherhood, race, and health a more nuanced understanding of the social historical mechanisms that pattern breastfeeding, and more broadly, racial disparities in health.
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Affiliation(s)
- Kristen Kirksey
- Department of Sociology, University of Connecticut, 344 Mansfield Road, Unit 1068, Storrs, CT, 06269, USA.
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Clinically integrated breastfeeding peer counseling and breastfeeding outcomes. J Perinatol 2021; 41:2095-2103. [PMID: 34035450 DOI: 10.1038/s41372-021-01096-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/12/2021] [Accepted: 05/06/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate whether clinically integrated breastfeeding peer counseling (ci-BPC) improved breastfeeding outcomes for a diverse cohort of Medicaid-enrolled patients. STUDY DESIGN Medical records were reviewed for a random subset of patients delivering 2014-2015 (baseline, N = 147) and 2017-2019 (post-implementation, N = 281). Chi-squared and logistic regression evaluated differences in breastfeeding initiation, exclusivity, and duration, and results were stratified by race/ethnicity. RESULTS Post-implementation, 90.4% of patients received ci-BPC. Compared to baseline, documented prenatal breastfeeding counseling increased from 5 to 84% (<0.001), and inpatient counseling increased from 12 to 55% (p < 0.001). Breastfeeding initiation was similar (86 to 89%, p = 0.28), while exclusivity increased from 21 to 31% (p = 0.03). Any breastfeeding ≥6 weeks increased from 29 to 65% (p < 0.001) and was most improved for Black (32 to 50%, p < 0.01) and Latinx patients (37 to 71%, p < 0.01). CONCLUSIONS ci-BPC was associated with significant improvement in breastfeeding exclusivity and duration, and may address breastfeeding disparities.
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Stamenkovic Z, Matejic B, Djikanovic B, Bjegovic-Mikanovic V. Surprising Differences in the Practice of Exclusive Breastfeeding in Non-Roma and Roma Population in Serbia. Front Public Health 2020; 8:277. [PMID: 32714892 PMCID: PMC7342049 DOI: 10.3389/fpubh.2020.00277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Exclusive breastfeeding is essential for early childhood development, although the use of adaptive milk formulas instead of breastfeeding is widespread nowadays. This study aimed to examine the prevalence of exclusively breastfed infants under the age of 6 months in non-Roma and Roma population and factors associated with this practice. Materials and Methods: This study is a secondary analysis of the Serbian Multiple Indicator Cluster Survey investigating non-Roma and Roma infants under the age of 6 months. The study included mothers of 321 non-Roma and 164 Roma infants younger than 6 months. Univariate and multivariate logistic regression served to analyze factors associated with the practice of exclusive breastfeeding in both populations. Results: The prevalence of exclusive breastfeeding was almost the same among mothers in both non-Roma and Roma population (13.3 vs. 13%, p = 0.910). Exclusive breastfeeding was significantly more often (p < 0.001) among wealthier women, women whose newborns were over 2,500 g on birth, multipara, and women who had not established menstrual cycle among both populations. Living outside the capital significantly diminishes the chance for exclusively breastfed infants in the non-Roma community (Vojvodina: OR 0.16, CI 95% 0.03–0.92; eastern Serbia: OR 0.02, CI 95% 0.01–0.35) as well as living in the rural area (urban: OR 10.35, CI 95% 1.94–55.28). Unexpectedly, in the non-Roma population, not staying in the same room with the newborn in the maternity ward increases the chance for the baby to be exclusively breastfed (OR 7.19, CI 95% 1.80–28.68). The same pattern has been observed in Roma population. Non-Roma mothers multipara are more likely to exclusively breastfeed their children than primipara (OR 7.78, CI 95% 1.09–20.93), while among Roma mothers, the inverse association has been found although not significant (OR 0.42, CI 95% 0.14–1.23). Attending a childbirth preparation program more than 18 times increases the chances of infants being exclusively breastfed (OR 18.65, CI 95% 1.34–53.67). In the Roma population, there was no single woman that attended a childbirth preparation program. Conclusion: The pattern of exclusive breastfeeding significantly differs between non-Roma and Roma populations. Preventive work should have focus on strengthening support to mothers and medical staff in maternity wards.
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Affiliation(s)
- Zeljka Stamenkovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bojana Matejic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
| | - Bosiljka Djikanovic
- Institute of Social Medicine, Medical Faculty University of Belgrade, Belgrade, Serbia
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Rujumba J, Ndeezi G, Nankabirwa V, Kwagala M, Mukochi M, Diallo AH, Meda N, Engebretsen IMS, Tylleskär T, Tumwine J. "If I have money, I cannot allow my baby to breastfeed only …" barriers and facilitators to scale-up of peer counselling for exclusive breastfeeding in Uganda. Int Breastfeed J 2020; 15:43. [PMID: 32414404 PMCID: PMC7229593 DOI: 10.1186/s13006-020-00287-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 05/06/2020] [Indexed: 01/13/2023] Open
Abstract
Background Early initiation and exclusive breastfeeding for 6 months reduces infant morbidity and mortality and can positively impact on cognitive function. In Uganda, exclusive breastfeeding for 6 months is recommended but many women introduce alternative feeds early. Interventions to scale-up peer support provision for exclusive breastfeeding are limited. We explored the barriers, facilitators and solutions to scaling-up of peer counselling support for exclusive breastfeeding in Uganda. Methods A qualitative study was conducted in Mbale District and Kampala City between April and July 2014. Data were collected through 15 key informant interviews with health workers and managers of organizations involved in child and maternal health as well as seven focus group discussions with peer counsellors who took part in the PROMISE EBF Trial (2006–2008), VHT members, mothers and fathers of children aged 1 year and below. Data were analysed using the content thematic approach. Results The need for peer support for exclusive breastfeeding, especially for young and first-time mothers, was highlighted by most study participants. While mothers, mothers-in-law, friends and husbands were mentioned as major stakeholders regarding infant feeding, they were perceived to lack adequate information on breastfeeding. Health workers were mentioned as a key source of support, but their constraints of heavy workloads and lack of education materials on breastfeeding were highlighted. High community expectations of peer counsellors, the perceived inadequacy of breast milk, general acceptability of complimentary feeding, household food insecurity, heavy workload for women and unsupportive ‘work-places’ were key barriers to scaling-up of peer counselling support for breastfeeding. The peer counsellors who were part of the PROMISE EBF trial in Mbale, the village health team programme, health facilities, community groups, the media and professional associations emerged as potential facilitators that can aid the scaling-up of peer counselling support for breastfeeding. Conclusions Peer support for breastfeeding is highly valued in this setting. The health system and health workers are regarded as the main facilitators to scaling-up of peer support for exclusive breastfeeding. Partnerships with village health teams (VHTs), community groups, role models, professional associations and the media are other potential facilitators to this scaling-up.
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Affiliation(s)
- Joseph Rujumba
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
| | - Grace Ndeezi
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | | | - Mary Kwagala
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Michelle Mukochi
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Abdoulaye Hama Diallo
- Department of Public Health, Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso.,Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | | | | | | | - James Tumwine
- Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda
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van de Vijver PL, Wielens H, Slaets JPJ, van Bodegom D. Vitality club: a proof-of-principle of peer coaching for daily physical activity by older adults. Transl Behav Med 2018; 8:204-211. [PMID: 29325113 DOI: 10.1093/tbm/ibx035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Many age-related diseases can be prevented or delayed by daily physical activity. Unfortunately, many older adults do not perform physical activity at the recommended level. Professional interventions do not reach large numbers of older adults for a long period of time. We studied a peer-coach intervention, in which older adults coach each other, that increased daily physical activity of community dwelling older adults for over 6 years. We studied the format and effects of this peer coach intervention for possible future implementation elsewhere. Through interviews and participatory observation we studied the format of the intervention. We also used a questionnaire (n = 55) and collected 6-min walk test data (n = 261) from 2014 to 2016 to determine the motivations of participants and effects of the intervention on health, well-being and physical capacity. Vitality Club is a self-sustainable group of older adults that gather every weekday to exercise coached by an older adult. Members attend on average 2.5 days per week and retention rate is 77.5% after 6 years. The members perceived improvements in several health measures. In line with this, the 6-min walk test results of members of this Vitality Club improved with 21.7 meters per year, compared with the decline of 2-7 meters per year in the general population. This Vitality Club is successful in durably engaging its members in physical activity. The members perceive improvements in health that are in line with improvements in a physical function test. Because of the self-sustainable character of the intervention, peer coaching has the potential to be scaled up at low cost and increase physical activity in the increasing number of older adults.
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Affiliation(s)
- Paul L van de Vijver
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Abstract
BACKGROUND Clinical lactation professionals, breastfeeding peer counseling, and mother-to-mother support are important sources of information and guidance for helping mothers initiate and maintain breastfeeding in the early weeks, months, and years postpartum. However, there is limited information concerning the geographic barriers that mothers face when seeking this support. Research aim: This study aimed to identify the geographic barriers to breastfeeding support, delineate gaps in access, assess inequities in the distribution of local support, and highlight the underlying differences in access and equity for different demographic and socioeconomic groups. METHODS The locations of formal breastfeeding support resources were collected for the state of Ohio for 2016 and were combined with demographic and socioeconomic estimates and derived transportation catchment areas to conduct an analysis of spatial access and equity. RESULTS Significant geographic gaps in formal breastfeeding support exist within the state of Ohio. Although urban areas benefit from a higher density of support options, including a wide variety of clinical experts and mother-to-mother support groups, inequities in exurban and rural areas were more strongly aligned with socioeconomic status than geography. In particular, the Special Supplemental Nutrition Program for Women, Infants, and Children offices in rural Ohio offer breastfeeding support to income-qualifying mothers but cannot address the needs of mothers who do not qualify. CONCLUSION Spatial analytical approaches facilitate a more nuanced view of access and equity to breastfeeding support options, helping to both decompose important structural differences in the state of Ohio and identify locations that could benefit from additional breastfeeding support resources.
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Affiliation(s)
- Tony H Grubesic
- 1 Center for Spatial Reasoning & Policy Analytics, College of Public Service & Community Solutions, Arizona State University, Phoenix, AZ, USA
| | - Kelly M Durbin
- 2 Childbirth International, Singapore.,3 LaLeche League International, Schaumburg, IL, USA
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12
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Eden AR. Breastfeeding Support: From Informal Care Work to Professional Health-Care Work. ANTHROPOLOGY OF WORK REVIEW 2017. [DOI: 10.1111/awr.12110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Dagher RK, McGovern PM, Schold JD, Randall XJ. Determinants of breastfeeding initiation and cessation among employed mothers: a prospective cohort study. BMC Pregnancy Childbirth 2016; 16:194. [PMID: 27472915 PMCID: PMC4966748 DOI: 10.1186/s12884-016-0965-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 07/12/2016] [Indexed: 11/20/2022] Open
Abstract
Background The U.S. continues to have one of the lowest breastfeeding rates in the industrialized world. Studies have shown that full-time employment and early return to work decreased breastfeeding duration, but little is known about the relationship between leave policies and breastfeeding initiation and cessation. This study aimed to identify workplace-related barriers and facilitators associated with breastfeeding initiation and cessation in the first 6 months postpartum. Methods A prospective cohort study design was utilized to recruit 817 Minnesota women aged 18 and older while hospitalized for childbirth. Selection criteria included English-speaking, employed mothers with a healthy, singleton birth. These women were followed up using telephone interviews at 6 weeks, 12 weeks, and 6 months after childbirth. The main study outcomes were breastfeeding initiation, measured during hospital enrollment, and breastfeeding cessation by 6 months postpartum. Results Women were 30 years old; 86 % were White, and 73 % were married. Breastfeeding rates were 81 % at childbirth, 67 % at 6 weeks, 49 % at 12 weeks, and 33 % at 6 months postpartum. Logistic regression revealed the odds of breastfeeding initiation were higher for women who: held professional jobs, were primiparae, had graduate degree, did not smoke prenatally, had no breastfeeding problems, and had family or friends who breastfeed. Survival analyses showed the hazard for breastfeeding cessation by 6 months was: higher for women who returned to work at any time during the 6 months postpartum versus those who did not return, lower for professional workers, higher among single than married women, higher for every educational category compared to graduate school, and higher for those with no family or friends who breastfeed. Conclusions While employer paid leave policy did not affect breastfeeding initiation or cessation, women who took shorter leaves were more likely to stop breastfeeding in the first 6 months postpartum. Future research should examine women’s awareness of employer policies regarding paid and unpaid leave.
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Affiliation(s)
- Rada K Dagher
- Department of Health Services Administration, School of Public Health, University of Maryland, College Park, MD, USA.
| | - Patricia M McGovern
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Jesse D Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Xian J Randall
- US Department of Housing and Urban Development, Washington, DC, USA
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14
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Rozga MR, Benton PA, Kerver JM, Olson BH. An Integrated Model of Breastfeeding Peer Counseling Support is Feasible and Associated with Improved Exclusive Breastfeeding. Matern Child Health J 2016; 20:2589-2598. [DOI: 10.1007/s10995-016-2086-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Kellams AL, Gurka KK, Hornsby PP, Drake E, Riffon M, Gellerson D, Gulati G, Coleman V. The Impact of a Prenatal Education Video on Rates of Breastfeeding Initiation and Exclusivity during the Newborn Hospital Stay in a Low-income Population. J Hum Lact 2016; 32:152-9. [PMID: 26289058 DOI: 10.1177/0890334415599402] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 07/11/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guidelines recommend prenatal education to improve breastfeeding rates; however, effective educational interventions targeted at low-income, minority populations are needed as they remain less likely to breastfeed. OBJECTIVE To determine whether a low-cost prenatal education video improves hospital rates of breastfeeding initiation and exclusivity in a low-income population. METHODS A total of 522 low-income women were randomized during a prenatal care visit occurring in the third trimester to view an educational video on either breastfeeding or prenatal nutrition and exercise. Using multivariable analyses, breastfeeding initiation rates and exclusivity during the hospital stay were compared. RESULTS Exposure to the intervention did not affect breastfeeding initiation rates or duration during the hospital stay. The lack of an effect on breastfeeding initiation persisted even after controlling for partner, parent, or other living at home and infant complications (adjusted odds ratio [OR] = 1.05, 95% CI, 0.70-1.56). In addition, breastfeeding exclusivity rates during the hospital stay did not differ between the groups (P = .87). CONCLUSION This study suggests that an educational breastfeeding video alone is ineffective in improving the hospital breastfeeding practices of low-income women. Increasing breastfeeding rates in this at-risk population likely requires a multipronged effort begun early in pregnancy or preconception.
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Affiliation(s)
- Ann L Kellams
- Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| | - Kelly K Gurka
- Department of Epidemiology, West Virginia University, Morgantown, WV, USA
| | - Paige P Hornsby
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Emily Drake
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Mark Riffon
- Department of Biostatistics, West Virginia University, Morgantown, WV, USA
| | | | - Gauri Gulati
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA
| | - Valerie Coleman
- Institute of Women's Health, Virginia Commonwealth University, Richmond, VA, USA
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16
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Schafer EJ, Williams NA, Digney S, Hare ME, Ashida S. Social Contexts of Infant Feeding and Infant Feeding Decisions. J Hum Lact 2016; 32:132-40. [PMID: 26744497 DOI: 10.1177/0890334415592850] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 06/01/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Infant feeding takes place within a network of social relationships. However, the social context in which infant feeding advice is received remains underresearched. OBJECTIVE The objective of this study was to evaluate the social contexts of infant feeding by examining individual and relationship characteristics of mothers and network members associated with advice to exclusively breastfeed, exclusively formula feed, or use a combination of breast milk and formula. METHODS Information about 287 network members was reported by 80 low-income mothers during a one-time survey. Characteristics of relationships associated with mothers receiving advice (exclusively breastfeed/formula feed, combination feed) from each network member were identified using 2-level logistic regression analyses. RESULTS Mothers had greater odds of receiving advice to exclusively breastfeed from network members who help make feeding decisions (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.35-4.42), exclusively breastfed their own child or children (OR, 6.99; 95% CI, 2.96-16.51), and were health care providers (OR, 4.82; 95% CI, 1.70-13.67). Mothers had greater odds of receiving advice to breastfeed in combination with formula from network members who provided emotional support (OR, 2.45; 95% CI, 1.31-4.55), combination fed their own child or children (OR, 4.85; 95% CI, 1.80-13.05), and had an opinion that was important to the mother (OR, 2.67; 95% CI, 1.13-6.33). Mothers had greater odds of receiving advice to exclusively formula feed from network members who exclusively formula fed their own child or children (OR, 2.23; 95% CI, 1.07-4.66) than those who did not. CONCLUSION Social relationship characteristics and network members' infant feeding experiences may have implications for the advice new mothers receive. Future research should investigate social contexts of infant feeding longitudinally to inform interventions.
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Affiliation(s)
- Ellen J Schafer
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Natalie A Williams
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Siri Digney
- Department of Social and Behavioral Sciences, University of Memphis School of Public Health, Memphis, TN, USA
| | - Marion E Hare
- Department of Preventive Medicine and Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
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Wong KL, Tarrant M, Lok KYW. Group versus Individual Professional Antenatal Breastfeeding Education for Extending Breastfeeding Duration and Exclusivity: A Systematic Review. J Hum Lact 2015; 31:354-66. [PMID: 25908110 DOI: 10.1177/0890334415583294] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 03/26/2015] [Indexed: 11/17/2022]
Abstract
Although breastfeeding initiation rates have increased substantially in many developed countries over the past several decades, breastfeeding duration and exclusivity remain suboptimal. In the antenatal period, both group and individual education interventions have been implemented to improve breastfeeding. The purpose of this review was to compare the effectiveness of group and individual antenatal professional education on breastfeeding exclusivity and duration. A systematic search of the literature was conducted using Medline (1946-June 2014), PubMed (1883-June 2014), the Cumulative Index to Nursing and Allied Health Literature (1947-June 2014), EMBASE (1947-June 2014), British Nursing Index (1994-June 2014), Google Scholar, and the Cochrane Library. Included studies were limited to health care professional-conducted education delivered to pregnant women only. Only studies reporting breastfeeding duration or exclusivity were included. Nineteen studies were included, of which 13 evaluated antenatal group education, 5 evaluated individual antenatal education, and 1 evaluated both a group and an individual antenatal education. When compared with standard care, 4 out of 12 studies supported the effectiveness of antenatal group education on breastfeeding duration or exclusivity, whereas 4 out of 6 studies supported the effectiveness of antenatal individual education. Two studies compared antenatal group education with peer-led education and neither study showed a significant difference in breastfeeding outcomes. The methodological heterogeneity and the small number of high quality studies limited our ability to draw firm conclusions about the effectiveness of either mode of antenatal education.
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Affiliation(s)
- Ka Lun Wong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Marie Tarrant
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
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18
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Thomson G, Balaam MC, Hymers K. Building social capital through breastfeeding peer support: insights from an evaluation of a voluntary breastfeeding peer support service in North-West England. Int Breastfeed J 2015; 10:15. [PMID: 25897318 PMCID: PMC4404123 DOI: 10.1186/s13006-015-0039-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 03/12/2015] [Indexed: 11/23/2022] Open
Abstract
Background Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013. Methods Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed. Results Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with’bonding’, ‘bridging’ and ‘linking’ forms of social capital. These insights illuminate how the peer support service facilitates ‘bonds’ with its members, and within and between women who access the service; how the service ‘bridges’ with individuals from different interests and backgrounds, and how ‘links’ were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified. Conclusions Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted.
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Affiliation(s)
- Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Marie-Clare Balaam
- Research in Childbirth and Health Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE UK
| | - Kirsty Hymers
- East Lancashire Hospitals NHS Trust, Royal Blackburn Hospital, Haslingden Road, Blackburn, Lancashire BB2 3HH UK
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19
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Breast, Formula and Combination Feeding in Relation to Childhood Obesity in Nova Scotia, Canada. Matern Child Health J 2015; 19:2048-56. [DOI: 10.1007/s10995-015-1717-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Rozga MR, Kerver JM, Olson BH. Self-reported reasons for breastfeeding cessation among low-income women enrolled in a peer counseling breastfeeding support program. J Hum Lact 2015; 31:129-37; quiz 189-90. [PMID: 25158829 DOI: 10.1177/0890334414548070] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Peer counseling programs have demonstrated efficacy in improving breastfeeding rates in the low-income population, but there is little research concerning why women enrolled in these programs ultimately discontinue breastfeeding. OBJECTIVE This study aimed to describe the self-reported reasons for discontinuing breastfeeding among women who are receiving peer counseling support by participant characteristics and timing of discontinuation. METHODS This study is a secondary analysis of data collected from 7942 participants who discontinued breastfeeding while enrolled in a peer counseling breastfeeding support program from 2005 to 2011. Reasons for discontinuing breastfeeding were assessed in relation to participant characteristics and weaning age using chi-square analyses and Kruskall-Wallis analyses of variance. RESULTS The most common reasons reported for discontinuing breastfeeding were mother's preference (39%) and low milk supply (21%), although reasons differed by age of infant weaning (P < .001). Among participants who discontinued the earliest, the most commonly cited reasons were breastfeeding challenges [median duration (interquartile range), 4.7 (2.0, 13.4) weeks], followed by low milk supply [8.9 (4.6, 19.1) weeks] and mother's preference [12.9 (5.0, 25.7) weeks]. Women who were younger, were less educated, were non-Hispanic black, were unmarried, and had no prior breastfeeding experience were the most likely to discontinue breastfeeding due to mother's preference. CONCLUSION Peer counselors are in a unique position to offer breastfeeding education and encouragement and may be able to use evidence presented here to anticipate specified concerns either prenatally or postpartum, to prevent early breastfeeding discontinuation.
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Affiliation(s)
- Mary R Rozga
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Beth H Olson
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
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21
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Oza-Frank R, Bhatia A, Smith C. Impact of peer counselors on breastfeeding outcomes in a nondelivery NICU setting. Adv Neonatal Care 2014; 14:E1-8. [PMID: 25000101 DOI: 10.1097/anc.0000000000000101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE 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. SUBJECTS A total of 596 mother-infant pairs admitted to Nationwide Children's Hospital, Columbus, Ohio, pre- and postlactation program expansion. DESIGN A descriptive pre-/posttest study as conducted. MAIN OUTCOME MEASURES 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.
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22
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Niela-Vilén H, Axelin A, Salanterä S, Melender HL. Internet-based peer support for parents: a systematic integrative review. Int J Nurs Stud 2014; 51:1524-37. [PMID: 24998788 DOI: 10.1016/j.ijnurstu.2014.06.009] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 06/05/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The Internet and social media provide various possibilities for online peer support. The aim of this review was to explore Internet-based peer-support interventions and their outcomes for parents. DESIGN A systematic integrative review. DATA SOURCES The systematic search was carried out in March 2014 in PubMed, Cinahl, PsycINFO and Cochrane databases. REVIEW METHODS Two reviewers independently screened the titles (n=1793), abstracts and full texts to decide which articles should be chosen. The inclusion criteria were: (1) an Internet-based community as an intervention, or at least as a component of an intervention; (2) the participants in the Internet-based community had to be mothers and/or fathers or pregnant women; (3) the parents had to interact and communicate with each other through the Internet-based community. The data was analysed using content analysis. When analysing peer-support interventions only interventions developed by researchers were included and when analysing the outcomes for the parents, studies that focused on mothers, fathers or both parents were separated. RESULTS In total, 38 publications met the inclusion criteria. Most of the studies focused on Internet-based peer support between mothers (n=16) or both parents (n=15) and seven focused on fathers. In 16 studies, the Internet-based interventions had been developed by researchers and 22 studies used already existing Internet peer-support groups, in which any person using the Internet could participate. For mothers, Internet-based peer support provided emotional support, information and membership in a social community. For fathers, it provided support for the transition to fatherhood, information and humorous communication. Mothers were more active users of Internet-based peer-support groups than fathers. In general, parents were satisfied with Internet-based peer support. The evidence of the effectiveness of Internet-based peer support was inconclusive but no harmful effects were reported in these reviewed studies. CONCLUSIONS Internet-based peer support provided informational support for parents and was accessible despite geographical distance or time constraints. Internet-based peer support is a unique form of parental support, not replacing but supplementing support offered by professionals. Experimental studies in this area are needed.
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Affiliation(s)
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Finland
| | - Sanna Salanterä
- Department of Nursing Science, University of Turku, Finland; Turku University Hospital, Finland
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Impact of peer counselling breast-feeding support programme protocols on any and exclusive breast-feeding discontinuation in low-income women. Public Health Nutr 2014; 18:453-63. [DOI: 10.1017/s1368980014000603] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectivePeer counselling (PC) programmes have been shown to improve breast-feeding outcomes in populations at risk for early discontinuation. Our objective was to describe associations between programme components (individual and combinations) and breast-feeding outcomes (duration and exclusivity) in a PC programme for low-income women.DesignSecondary analysis of programme data. Multivariable-adjusted Cox proportional hazards models were used to examine associations between type and quantity of peer contacts with breast-feeding outcomes. Types of contacts included in-person (hospital or home), phone or other (e.g. mail, text). Quantities of contacts were considered ‘optimal’ if they adhered to standard programme guidelines.SettingProgramme data collected from 2005 to 2011 in Michigan’s Breastfeeding Initiative Peer Counseling Program.SubjectsLow-income (n 5886) women enrolled prenatally.ResultsFor each additional home, phone and other PC contact there was a significant reduction in the hazard of discontinuing any breast-feeding by 6 months (hazard ratio (HR)=0·90 (95 % CI 0·88, 0·92); HR=0·89 (95 % CI 0·87, 0·90); and HR=0·93 (95 % CI 0·90, 0·96), respectively) and exclusive breast-feeding by 3 months (HR=0·92 (95 % CI 0·89, 0·95); HR=0·90 (95 % CI 0·88, 0·91); and HR=0·93 (95 % CI 0·89, 0·97), respectively). Participants receiving greater than optimal in-person and less than optimal phone contacts had a reduced hazard of any and exclusive breast-feeding discontinuation compared with those who were considered to have optimum quantities of contacts (HR=0·17 (95 % CI 0·14, 0·20) and HR=0·28 (95 % CI 0·23, 0·35), respectively).ConclusionsSpecific components of a large PC programme appeared to have an appreciable impact on breast-feeding outcomes. In-person contacts were essential to improving breast-feeding outcomes, but defining optimal programme components is complex.
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24
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Meier PP, Engstrom JL, Rossman B. Breastfeeding peer counselors as direct lactation care providers in the neonatal intensive care unit. J Hum Lact 2013; 29:313-22. [PMID: 23563112 DOI: 10.1177/0890334413482184] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In 2005, the Level III neonatal intensive care unit (NICU) at Rush University Medical Center initiated a demonstration project employing breastfeeding peer counselors, former parents of NICU infants, as direct lactation care providers who worked collaboratively with the NICU nurses. This article describes the conceptualization, implementation, and evaluation of this program and provides templates for other NICUs that wish to incorporate breastfeeding peer counselors with the goal of providing quality, evidence-based lactation care.
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Affiliation(s)
- Paula P Meier
- Rush University Medical Center, Chicago, IL 60612, USA.
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25
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Peters KE, Huang J, Vaughn MG, Witko C. Does breastfeeding contribute to the racial gap in reading and math test scores? Ann Epidemiol 2013; 23:646-51. [PMID: 23880156 DOI: 10.1016/j.annepidem.2013.06.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/17/2013] [Accepted: 06/17/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this study was to examine the impact of divergent breastfeeding practices between Caucasian and African American mothers on the lingering achievement test gap between Caucasian and African American children. METHODS The Child Development Supplement of the Panel Study of Income Dynamics, beginning in 1997, followed a cohort of 3563 children aged 0-12 years. Reading and math test scores from 2002 for 1928 children were linked with breastfeeding history. Regression analysis was used to examine associations between ever having been breastfed and duration of breastfeeding and test scores, controlling for characteristics of child, mother, and household. RESULTS African American students scored significantly lower than Caucasian children by 10.6 and 10.9 points on reading and math tests, respectively. After accounting for the impact of having been breastfed during infancy, the racial test gap decreased by 17% for reading scores and 9% for math scores. CONCLUSIONS Study findings indicate that breastfeeding explains 17% and 9% of the observed gaps in reading and math scores, respectively, between African Americans and Caucasians, an effect larger than most recent educational policy interventions. Renewed efforts around policies and clinical practices that promote and remove barriers for African American mothers to breastfeed should be implemented.
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Affiliation(s)
- Kristen E Peters
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St Louis, MO.
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26
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Thomson G, Crossland N. Callers' attitudes and experiences of UK breastfeeding helpline support. Int Breastfeed J 2013; 8:3. [PMID: 23628104 PMCID: PMC3651704 DOI: 10.1186/1746-4358-8-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers' experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). METHODS A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers' experiences of the help and support received via the breastfeeding helpline(s). RESULTS Overall satisfaction with the helpline was high, with the vast majority of callers' recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of 'contact with the helplines'; 'experiences of the helpline service', 'perceived effectiveness of support provision' and 'impact on caller wellbeing'. CONCLUSION Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women's breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted.
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Affiliation(s)
- Gill Thomson
- Maternal & Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Nicola Crossland
- Maternal & Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, PR1 2HE, UK
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27
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Furman LM, Dickinson C. Community health workers: collaborating to support breastfeeding among high-risk inner-city mothers. Breastfeed Med 2013; 8:73-8. [PMID: 22891963 DOI: 10.1089/bfm.2012.0027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Low breastfeeding rates persist as a health disparity among high-risk inner-city mothers. We sought to obtain input of community health workers (CHWs) in preparation for a breastfeeding intervention. SUBJECTS AND METHODS We conducted audiotaped focus groups with CHWs of the Cleveland (OH) Department of Public Health's MomsFirst™, a federally funded Healthy Start program, which addressed interest in breastfeeding, positives and negatives of breastfeeding, perceived barriers, and an intervention concept. We used notes-based and tape-based analysis with a previously developed theme code modified for breastfeeding relevance. RESULTS Seventeen (50%) of 34 actively employed CHWs participated in two focus groups. Issues that emerged were as follows: (1) breastfeeding is "hard" for young mothers, with multiple obstacles identified, including lack of support at home, pain with nursing, extra time required, incompatibility with medications and lifestyle, body image concerns, and "no equipment" (breast pumps); (2) expected supports such as postpartum hospital care have not been helpful, and in-home help is needed; (3) many CHWs' personal breastfeeding experiences were difficult; (4) CHWs requested additional breastfeeding education for themselves; and (5) while strongly endorsing "making a difference" in their clients' lives, CHWs worried that additional curricular mandates would create burden that could become a disincentive. CONCLUSIONS CHWs who make home visits are in a unique position to impact their clients' breastfeeding decisions. A targeted intervention for high-risk inner-city mothers must meet the educational needs of the teachers (CHWs) while minimizing administrative burden, address issues identified by the clients (mothers), and provide hands-on help within the home.
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Affiliation(s)
- Lydia M Furman
- Rainbow Babies and Children’s Hospital and Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
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Kaunonen M, Hannula L, Tarkka MT. A systematic review of peer support interventions for breastfeeding. J Clin Nurs 2012; 21:1943-54. [PMID: 22672457 DOI: 10.1111/j.1365-2702.2012.04071.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The objective of this systematic review was to describe peer support interventions supporting breastfeeding during pregnancy and the postnatal period. BACKGROUND Breastfeeding is an effective way to promote infants' health. Including a peer support element in breastfeeding programmes is a highly successful way to increase breastfeeding. DESIGN A systematic literature review. METHODS The review was conducted from the CINAHL, MEDLINE and the Cochrane Library databases from year 2000 until the end of February 2008. According to the inclusion criteria, the adopted studies focused on breastfeeding, breastfeeding support interventions and education of healthy mothers and infants from the perspective of mothers or family members. Additionally, the studies had to be conducted in Europe, North America, Australia or New Zealand to meet the criteria. Articles combining peer support and professional support were also included in the study. RESULTS The results indicated that during pregnancy, hospitalisation and the postnatal period, individual support and education were used most commonly. Peer support was strongly associated with the postnatal period. The combination of professional support and peer support by trained and experienced peer supporters was effective in ensuring the continuation of breastfeeding. CONCLUSIONS Only continuous breastfeeding support produces effective results. Diverse types of interventions are needed during different phases of motherhood. The role of peer support is most important during the postnatal period. If professional support is not available for mothers, peer support could provide an alternative worth considering. RELEVANCE TO CLINICAL PRACTICE Professionals require breastfeeding education to act as breastfeeding supporters as well as the support of their organisations in this work. Moreover, professionals need to gain knowledge of the role of peer support regarding the efficient combination of professional support and peer support to increase breastfeeding.
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Affiliation(s)
- Marja Kaunonen
- School of Health Sciences, University of Tampere, Tampere University Hospital/Science Center, Tampere, Finland.
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Guyer J, Millward LJ, Berger I. Mothers' breastfeeding experiences and implications for professionals. ACTA ACUST UNITED AC 2012. [DOI: 10.12968/bjom.2012.20.10.724] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Julie Guyer
- Julie Guyer Department of Psychology, Faculty of Arts and Human Sciences, University of Surrey
| | - Lynne J Millward
- Lynne J Millward Late Reader in Psychology, Faculty of Arts and Human Sciences, University of Surrey
| | - Israel Berger
- Israel Berger Research Fellow, Psychology, Faculty of Arts and Human Sciences, University of Surrey
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Rossman B, Engstrom JL, Meier PP. Healthcare providers' perceptions of breastfeeding peer counselors in the neonatal intensive care unit. Res Nurs Health 2012; 35:460-74. [PMID: 22753129 DOI: 10.1002/nur.21496] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2012] [Indexed: 11/08/2022]
Abstract
In this qualitative descriptive study we examined the perceptions of 17 neonatal intensive care unit (NICU) healthcare providers (nurses, neonatologists, lactation consultants, and dietitians) about the role of breastfeeding peer counselors who were mothers of former NICU infants and who provided primary lactation care in the NICU. Findings revealed that the healthcare providers respected the peer counselors' lactation expertise and identified three critical elements that contributed to the effectiveness of the peer counseling program: having a champion for the program, counselors being mothers of former NICU infants, and a NICU culture supportive of using human milk. Healthcare providers thought the peer counselors enhanced care of the infant by empowering mothers to provide milk and by facilitating and modeling positive patterns of maternal-infant interactions.
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Affiliation(s)
- Beverly Rossman
- Department of Women, Children, and Family Nursing, College of Nursing, Armour Academic Center, Rush University, Chicago, IL 60612-3832, USA
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Measuring the Impact and Outcomes of Maternal Child Health Federal Programs. Matern Child Health J 2012; 17:886-96. [DOI: 10.1007/s10995-012-1067-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Bignell WE, Sullivan E, Andrianos A, Anderson AK. Provision of support strategies and services: results from an internet-based survey of community-based breastfeeding counselors. J Hum Lact 2012; 28:62-76. [PMID: 22267320 DOI: 10.1177/0890334411429112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined the determinants of support strategies and services provided by community-based breastfeeding counselors (CBBCs) and compared differences in extent of support provided by paid and volunteer counselors. Participants (N = 847) in this internet-based survey were mostly White/Caucasian (74.9%), college-educated (59.0%), and paid CBBCs (63.8%). The majority (75.9%) of volunteer CBBCs compared with their paid full-time (52.1%) and paid part-time (47.4%) counterparts had completed college. Being a full-time paid compared with volunteer/unpaid CBBC was associated with face-to-face counseling (OR = 3.69; 95% CI: 1.93, 7.06), use of client-centered counseling skills (OR = 6.23; 95% CI: 3.40, 11.45), making referrals to social service agencies (OR = 13.18; 95% CI: 6.86, 25.32), and helping position baby (OR = 3.77; 95% CI: 1.64, 8.69). Because of the disparities in CBBC usage of breastfeeding support strategies and continuing education between paid and volunteer CBBCs, there is a need to examine differences in training curricula and determine the facilitators and barriers of continuing education.
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Affiliation(s)
- Whitney E Bignell
- Department of Foods and Nutrition, University of Georgia, Athens, Georgia 30602, USA
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Sullivan EM, Bignell WE, Andrianos A, Anderson AK. Impact of education and training on type of care provided by community-based breastfeeding counselors: a cross-sectional study. Int Breastfeed J 2011; 6:12. [PMID: 21871062 PMCID: PMC3177880 DOI: 10.1186/1746-4358-6-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 08/26/2011] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Studies using community-based breastfeeding counselors (CBBCs) have repeatedly shown positive impact on breastfeeding initiation, exclusivity and duration, particularly among low-income mothers. To date, there has not been a comprehensive study to determine the impact of CBBC attributes such as educational background and training, on the type of care that CBBCs provide. METHODS This was a cross-sectional study of a convenience sample of CBBCs to ascertain the influence of counselor education and type of training on type of support and proficiency of CBBCs in communities across the United States. Invitations to participate in this online survey of CBBCs were e-mailed to program coordinators of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), La Leche League, and other community-based health organizations, who in turn invited and encouraged their CBBCs to participate. Descriptive analysis was used to describe participants (N = 847), while bivariate analysis using χ2 test was used to examine the differences between CBBC education, training received and breastfeeding support skills used. Multivariate logistic regression was used to assess the independent determinants of specific breastfeeding support skills. RESULTS The major findings from the research indicate that overall, educational attainment of CBBCs is not a significant predictor for the curriculum used in their training and type of support skills used during counseling sessions, but initial training duration was positively associated with the use of many breastfeeding support skills. Another major influence of counselor support to clients is the type of continuing education they receive after their initial training, with higher likelihood of use of desirable support skills associated with counselors continuing their breastfeeding education at conferences or trainings away from their job sites. CONCLUSIONS Our results show that different programs use different training curricula to train their CBBCs varying in duration and content. Counselor education is not a significant predictor of the type of training they receive. Continuing breastfeeding education is a significant determinant of type of counseling techniques used with clients. Further research is therefore needed to critically examine the content of the various training curricula of CBBC programs. This may show a need for a standardized training curriculum for all CBBC programs worldwide to make CBBCs more proficient and efficient, ensuring successful and optimum breastfeeding experiences for mothers and their newborns.
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Affiliation(s)
- Elizabeth M Sullivan
- Department of Foods and Nutrition, University of Georgia, 280 Dawson Hall, Athens, GA 30602, USA
| | - Whitney E Bignell
- Department of Foods and Nutrition, University of Georgia, 280 Dawson Hall, Athens, GA 30602, USA
| | - Anne Andrianos
- International Board of Lactation Consultant Examiners, 6402 Arlington Boulevard, Suite 350, Falls Church, VA 22042, USA
| | - Alex K Anderson
- Department of Foods and Nutrition, University of Georgia, 280 Dawson Hall, Athens, GA 30602, USA
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Rossman B, Engstrom JL, Meier PP, Vonderheid SC, Norr KF, Hill PD. "They've walked in my shoes": mothers of very low birth weight infants and their experiences with breastfeeding peer counselors in the neonatal intensive care unit. J Hum Lact 2011; 27:14-24. [PMID: 21173423 DOI: 10.1177/0890334410390046] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effectiveness of the breastfeeding peer counselor role is thought to be embedded in the relationship between new and experienced mothers. In this study, new mothers of very low birth weight infants emphasized that one of the most important aspects of their relationship with the breastfeeding peer counselors is the peer or shared experience of how difficult it can be to provide milk and breastfeed while coping with the emotional stress of having an infant in the neonatal intensive care unit. This study provides evidence for the promotion and facilitation of lactation for mothers of neonatal intensive care unit infants through the use of breastfeeding peer counselors who are peers by virtue of the shared experience of providing milk for an infant hospitalized in the neonatal intensive care unit.
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Affiliation(s)
- Beverly Rossman
- Department of Women, Children, and Family Nursing, Rush University Medical Center College of Nursing, Armour Academic Center, 674 Driftwood Lane, Northbrook, IL 60062, USA
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Rojjanasrirat W, Sousa VD. Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA. J Clin Nurs 2011; 19:2014-22. [PMID: 20920027 DOI: 10.1111/j.1365-2702.2009.03152.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To describe the perceptions of breastfeeding in low-income pregnant women to understand their needs better as they plan to return to work or school. BACKGROUND Maternal employment has a negative impact on breastfeeding duration. Yet there is insufficient research on challenges and facilitators regarding breastfeeding and employment issue among low-income women in the USA. Knowing the perceptions of breastfeeding among low-income pregnant women and their plan to return to work or school may have implications for nurses and midwives in providing quality care. DESIGN Qualitative study using focus group interviews. METHODS The research setting consisted of three Women, Infants and Children clinics (WIC) in a midwestern city of the USA. Seventeen pregnant women (aged 19-35) participated in focus group interviews. Data were coded and analysed for themes and patterns using the QSR software - NVivo 6. RESULTS Eleven participants were single. Ten women were primigravida, and seven were multipara. The following five themes were identified: (1) perceived benefits of breastfeeding; (2) general perceptions of breastfeeding; (3) maternal concerns; (4) having the right support; and (5) anticipated challenges of combining breastfeeding and work. Conclusions. Low-income women anticipated substantial barriers for breastfeeding when they planned to combine breastfeeding and work or school. The results of this study have many implications for public health practice, research and policy. Educating employers and the public at large about the health and economic benefits derived from long-term breastfeeding could help promote breastfeeding awareness. RELEVANCE TO CLINICAL PRACTICE Strategies supporting breastfeeding among low-income working women must be provided at multiple levels to help overcome the barriers they concern. Health care providers should help women gain confidence by minimising their uncertainties and fears about breastfeeding to prepare them to continue breastfeeding successfully after returning to work.
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Lewallen LP, Street DJ. Initiating and Sustaining Breastfeeding in African American Women. J Obstet Gynecol Neonatal Nurs 2010; 39:667-74. [DOI: 10.1111/j.1552-6909.2010.01196.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Chapman DJ, Morel K, Anderson AK, Damio G, Pérez-Escamilla R. Breastfeeding peer counseling: from efficacy through scale-up. J Hum Lact 2010; 26:314-26. [PMID: 20715336 PMCID: PMC3115698 DOI: 10.1177/0890334410369481] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An increasing number of publications have evaluated various breastfeeding peer counseling models. This article describes a systematic review of (a) the randomized trials assessing the effectiveness of breastfeeding peer counseling in improving rates of breastfeeding initiation, duration, exclusivity, and maternal and child health outcomes and (b) scientific literature describing the scale-up of breastfeeding peer counseling programs. Twenty-six peer-reviewed publications were included in this review. The overwhelming majority of evidence from randomized controlled trials evaluating breastfeeding peer counseling indicates that peer counselors effectively improve rates of breastfeeding initiation, duration, and exclusivity. Peer counseling interventions were also shown to significantly decrease the incidence of infant diarrhea and significantly increase the duration of lactational amenorrhea. Breastfeeding peer counseling initiatives are effective and can be scaled up in both developed and developing countries as part of well-coordinated national breastfeeding promotion or maternal-child health programs.
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Affiliation(s)
- Donna J Chapman
- University of Connecticut, Center for Eliminating Health Disparities Among Latinos, Department of Nutritional Sciences, 3624 Horsebarn Road Extension, Storrs, CT 06269-4017, USA
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Meier PP, Engstrom JL, Patel AL, Jegier BJ, Bruns NE. Improving the use of human milk during and after the NICU stay. Clin Perinatol 2010; 37:217-45. [PMID: 20363457 PMCID: PMC2859690 DOI: 10.1016/j.clp.2010.01.013] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The feeding of human milk (milk from the infant's own mother; excluding donor milk) during the newborn intensive care unit (NICU) stay reduces the risk of costly and handicapping morbidities in premature infants. The mechanisms by which human milk provides this protection are varied and synergistic, and appear to change over the course of the NICU stay. The fact that these mechanisms include specific human milk components that are not present in the milk of other mammals means that human milk from the infant's mother cannot be replaced by commercial infant or donor human milk, and the feeding of human milk should be a NICU priority. Recent evidence suggests that the impact of human milk on improving infant health outcomes and reducing the risk of prematurity-specific morbidities is linked to specific critical exposure periods in the post-birth period during which the exclusive use of human milk and the avoidance of commercial formula may be most important. Similarly, there are other periods when high doses, but not necessarily exclusive use of human milk, may be important. This article reviews the concept of "dose and exposure period" for human milk feeding in the NICU to precisely measure and benchmark the amount and timing of human milk use in the NICU. The critical exposure periods when exclusive or high doses of human milk appear to have the greatest impact on specific morbidities are reviewed. Finally, the current best practices for the use of human milk during and after the NICU stay for premature infants are summarized.
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Affiliation(s)
- Paula P Meier
- Department of Women, Children and Family Nursing, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA.
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Pugh LC, Serwint JR, Frick KD, Nanda JP, Sharps PW, Spatz DL, Milligan RA. A randomized controlled community-based trial to improve breastfeeding rates among urban low-income mothers. Acad Pediatr 2010; 10:14-20. [PMID: 19854119 PMCID: PMC2818063 DOI: 10.1016/j.acap.2009.07.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Revised: 07/10/2009] [Accepted: 07/19/2009] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to assess whether providing a breastfeeding support team results in higher breastfeeding rates at 6, 12, and 24 weeks postpartum among urban low-income mothers. DESIGN A randomized controlled trial with mother-infant dyads recruited from 2 urban hospitals. PARTICIPANTS Breastfeeding mothers of full-term infants who were eligible for Special Supplemental Nutrition Program for Women, Infants, and Children (n=328) were randomized to intervention (n=168) or usual-care group (n=160). INTERVENTION The 24-week intervention included hospital visits by a breastfeeding support team, home visits, telephone support, and 24-hour pager access. The usual-care group received standard care. OUTCOME MEASURE Breastfeeding status was assessed by self-report at 6, 12, and 24 weeks postpartum. RESULTS There were no differences in the sociodemographic characteristics between the groups: 87% were African American, 80% single, and 51% primiparous. Compared with the usual-care group, more women reported breastfeeding in the intervention at 6 weeks postpartum, 66.7% vs 56.9% (odds ratio, 1.71; 95% confidence interval, 1.07-2.76). The difference in rates at 12 weeks postpartum, 49.4% vs 40.6%, and 24 weeks postpartum, 29.2% vs 28.1%, were not statistically significant. CONCLUSIONS The intervention group was more likely to be breastfeeding at 6 weeks postpartum compared with the usual-care group, a time that coincided with the most intensive part of the intervention.
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Affiliation(s)
- Linda C. Pugh
- York College of Pennsylvania 441 Country Club Road York, PA 17403
| | - Janet R. Serwint
- Johns Hopkins University School of Medicine General Pediatrics and Adolescent Medicine Baltimore, Maryland
| | - Kevin D. Frick
- Johns Hopkins University Bloomberg School of Public Health Department of Health and Policy Management Baltimore, Maryland
| | - Joy P. Nanda
- Johns Hopkins University Bloomberg School of Public Health Department of Population, Family, and Reproductive Health Sciences Baltimore, Maryland
| | | | - Diane L. Spatz
- University of Pennsylvania School of Nursing Philadelphia, Pennsylvania
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Gross SM, Resnik AK, Cross-Barnet C, Nanda JP, Augustyn M, Paige DM. The differential impact of WIC peer counseling programs on breastfeeding initiation across the state of Maryland. J Hum Lact 2009; 25:435-43. [PMID: 19652195 DOI: 10.1177/0890334409342070] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This cross-sectional study examines Maryland's women, infants, and children (WIC) breastfeeding initiation rates by program participation. The authors report on data regarding demographic and health characteristics and infant feeding practices for infants (n = 18,789) newly WIC-certified from January 1, 2007 to June 30, 2007. The authors compared self-reported, breastfeeding initiation rates for 3 groups: peer counselor (PC-treatment group) and two comparison groups, lactation consultant (LC), and standard care group (SCG). Reported breastfeeding initiation at certification was 55.4%. Multiple logistic regression analysis, controlling for relevant maternal and infant characteristics, showed that the odds of breastfeeding initiation were significantly greater among PC-exposed infants (OR [95% CI] 1.27 [1.18, 1.37]) compared to the reference group of SCG infants, but not significantly different between LC infants (1.04 [0.96, 1.14]) and the SCG. LC and SCG infants had similar odds of breastfeeding initiation. In the Maryland WIC program, breastfeeding initiation rates were positively associated with peer counseling.
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Affiliation(s)
- Susan M Gross
- Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, Johns Hopkins University, W4033 Wolfe Street Building, 615 North Wolfe Street, Baltimore, MD 21205, USA.
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Pérez-Escamilla R, Hromi-Fiedler A, Vega-López S, Bermúdez-Millán A, Segura-Pérez S. Impact of peer nutrition education on dietary behaviors and health outcomes among Latinos: a systematic literature review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2008; 40:208-25. [PMID: 18565462 PMCID: PMC2746903 DOI: 10.1016/j.jneb.2008.03.011] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Revised: 03/13/2008] [Accepted: 03/19/2008] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This systematic review assesses the impact of peer education/counseling on nutrition and health outcomes among Latinos and identifies future research needs. DESIGN A systematic literature search was conducted by: (1) searching Internet databases; (2) conducting backward searches from reference lists of articles of interest; (3) manually reviewing the archives of the Center for Eliminating Health Disparities among Latinos; (4) searching the Journal of Nutrition Education and Behavior; and (5) directly contacting researchers in the field. The authors reviewed 22 articles derived from experimental or quasi-experimental studies. OUTCOME MEASURES Type 2 diabetes behavioral and metabolic outcomes, breastfeeding, nutrition knowledge, attitudes and behaviors. RESULTS Peer nutrition education has a positive influence on diabetes self-management and breastfeeding outcomes, as well as on general nutrition knowledge and dietary intake behaviors among Latinos. CONCLUSIONS AND IMPLICATIONS There is a need for longitudinal randomized trials testing the impact of peer nutrition education interventions grounded on goal setting and culturally appropriate behavioral change theories. Inclusion of reliable scales and the construct of acculturation are needed to further advance knowledge in this promising field. Operational research is also needed to identify the optimal peer educator characteristics, the type of training that they should receive, the client loads and dosage (ie, frequency and amount of contact needed between peer educator and client), and the best educational approaches and delivery settings.
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Affiliation(s)
- Rafael Pérez-Escamilla
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Amber Hromi-Fiedler
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Sonia Vega-López
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Angela Bermúdez-Millán
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
| | - Sofia Segura-Pérez
- Hispanic Health Council, Hartford CT
- Connecticut Center for Eliminating Health Disparities among Latinos
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