Abstract
OBJECTIVE: To evaluate the effectiveness of different quantities and types of breastfeeding (BF) peer counselor (BFPC) support on BF outcomes in women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DESIGN: Secondary data analysis using BFPC data from an upstate New York county WIC (April 1, 2009 to March 30, 2011) merged with New York State Department of Health WIC surveillance data. PARTICIPANTS: A total of 2,149 WIC-enrolled mothers with live singleton births who accepted a BFPC referral and received different quantities and types of BFPC support (telephone, in person, and mailings). MAIN OUTCOME MEASURES: Self-reported BF initiation and duration at 30 days. ANALYSIS: Multivariable logistic regression was used to estimate the odds of BF outcomes at 30 days associated with different levels of BFPC support. RESULTS: Mothers who accepted BFPC referrals and had at least 1 phone conversation or in-person contact had a significant 35% to 164% increased odds of positive BF outcomes. Mailings did not significantly improve outcomes. CONCLUSIONS AND IMPLICATIONS: The Special Supplemental Nutrition Program for Women, Infants, and Children may need to identify barriers to BF duration and implement interventions in communities with low BF rates. Future studies may benefit from evaluating the impact of combined in-person support and phone contacts during the prenatal and postpartum periods on BF outcomes.