Evaluation of the Missouri WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) breast-feeding peer counselling programme

Abstract

Objective: To evaluate the effectiveness of the peer counselling (PC) programme on breast-feeding initiation among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Missouri, and to identify factors that facilitate breast-feeding initiation.Design: We used the data from the 2006 Missouri Pregnancy Nutrition Surveillance System, Missouri Live Birth Records and the Missouri WIC programme to compare breast-feeding initiation rates between PC and non-PC agencies. We used multilevel logistic regression, with individual participants being nested within agencies, to control for individual-and agency-level characteristics. Results: The breast-feeding initiation rate in PC agencies was significantly higher than in non-PC agencies among prenatal participants, but the difference was not significant among postpartum participants. After controlling for maternal sociodemographic characteristics, compared with prenatal cases in non-PC agencies, prenatal cases in PC agencies were more likely to initiate breast-feeding (OR 5 1?21; 95 % CI 1?03, 1?43), whereas postpartum cases were less likely to initiate breast-feeding. Among prenatal participants in PC agencies, longer duration of prenatal WIC enrolment was associated with a higher rate of breast-feeding initiation. After adjusting for maternal sociodemographic characteristics and other agency-level characteristics, participants of PC agencies with an international board-certified lactation consultant were more likely to initiate breast-feeding than participants of PC agencies without such a consultant (OR 5 1?21; 95 % CI 1?01, 1?45). Conclusions: Prenatal participation in the WIC breast-feeding PC programme (especially participation early during pregnancy) was associated with an increased rate of breast-feeding initiation in Missouri.

A novel peer-support intervention using motivational interviewing for breastfeeding maintenance: a UK feasibility study

“…29,34,35,[37][38][39][80][81][82][83][84][85][86][87][88][89] Nine interventions were delivered in the USA, all associated with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). [80][81][82][83][84][85][86][87]89 Five papers related to UK-based interventions 34,35,[37][38][39]88 and one intervention was delivered in Canada. 29 Studies were included if they pertained to a model of BFPS that included planned one-to-one contact between a mother and a peer supporter, reported breastfeeding rates (initiation, continuation or exclusivity) as an outcome measure and if they had been delivered in a developed country setting.…”

“…Eleven studies were RCTs, 29,34,35,37,80,81,84,[86][87][88][89] three were area-based controlled studies 38,82,83 and two were natural experiments. 39,85 Applying Cochrane risk of bias criteria, 91 we found that only three studies had a low risk of bias.…”

“…39,85 Applying Cochrane risk of bias criteria, 91 we found that only three studies had a low risk of bias. 34,81,86 Six of the evaluations were at a risk of selection bias, 29,38,39,82,83,85 attrition may have affected six evaluations 35,37,80,83,87,88 and one evaluation 89 was at a risk of detection bias. Implementation issues affected 11 of the 15 evaluations.…”

“…With regard to the breastfeeding rate problem being addressed in the studies, nine interventions aimed to increase initiation rates 33,35,38,39,80,83,85,87,88 and 12 sought to improve continuation rates, 29,34,35,[37][38][39]80,81,84,85,87,89 measured at varying time points. Two interventions were intended to improve the rates of exclusive breastfeeding.…”

Telephone Peer Counseling of Breastfeeding Among WIC Participants: A Randomized Controlled Trial

“…[4][5][6][7][8][9][10][11][12] The common approach in these studies has been to compare the outcomes of WIC clients in LWAs with and without a peer counseling program. 4,5,6,8,12 A systematic literature review of peer counseling initiatives has characterized many of these observational studies as being of moderate to poor quality. 13 Reviews limited to randomized controlled trials (RCTs) of peer counseling have found that lay support increases exclusive and nonexclusive breastfeeding duration.…”