A Randomized Controlled Community-Based Trial to Improve Breastfeeding Rates Among Urban Low-Income Mothers
Received 15 December 2008; accepted 19 July 2009. published online 26 October 2009.
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.
Methods
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.
York College of Pennsylvania, York, Pa (Dr Pugh); General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, Md (Dr Serwint); Department of Health Policy and Management (Dr Frick) and Department of Population, Family, and Reproductive Health (Dr Nanda), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md; Johns Hopkins University School of Nursing, Baltimore, Md (Dr Sharps); University of Pennsylvania School of Nursing, Philadelphia, Pa (Dr Spatz); and George Mason University, Fairfax, Va (Dr Milligan)
Address correspondence to Linda C. Pugh, PhD, RNC, CNE, FAAN, 441 Country Club Rd, York, Pennsylvania 17403.
ABSTRACT