Feasibility and acceptability of a text message intervention used as an adjunct tool by WIC breastfeeding peer counsellors: The LATCH pilot

Abstract

Breastfeeding rates among mothers in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower than for other mothers in the United States. The objective of this study was to test the acceptability and feasibility of the Lactation Advice thru Texting Can Help intervention. Mothers were enrolled at 18-30 weeks gestation from two WIC breastfeeding peer counselling (PC) programmes if they intended to breastfeed and had unlimited text messaging, more than fifth-grade literacy level, and fluency in English or Spanish. Participants were randomized to the control arm (PC support without texting) or the intervention arm (PC support with texting). The two-way texting intervention provided breastfeeding education and support from peer counsellors. Primary outcomes included early post-partum (PP) contact and exclusive breastfeeding (EBF) rates at 2 weeks PP. Feasibility outcomes included text messaging engagement and mother's satisfaction with texting platform. Fifty-eight women were enrolled, 52 of whom were available for intention-to-treat analysis (n = 30 texting, n = 22 control). Contact between mothers and PCs within 48 hr of delivery was greater in the texting group (86.6% vs.27.3%, p < .001). EBF rates at 2 weeks PP among participants in the texting intervention was 50% versus 31.8% in the control arm (p = .197). Intervention group mothers tended to be more likely to meet their breastfeeding goals (p = .06). Participants were highly satisfied with the Lactation Advice thru Texting Can Help intervention, and findings suggest that it may improve early post-delivery contact and increase EBF rates among mothers enrolled in WIC who receive PC. A large, multicentre trial is feasible and warranted. KEYWORDS breastfeeding, breastfeeding support, infant, low income, peer support, newborn feeding behaviours

Racism, Bias, and Discrimination as Modifiable Barriers to Breastfeeding for African American Women: A Scoping Review of the Literature

“…Absent or limited family and/or peer support, reduced knowledge of breastfeeding benefits, inadequate access to breastfeeding education, and reduced maternal self‐efficacy have been identified as modifiable barriers to breastfeeding among African American women . Several researchers have studied multiprong interventions to increase breastfeeding rates among African American women . Such interventions have resulted in limited success.…”

“…[10][11][12] Several researchers have studied multiprong interventions to increase breastfeeding rates among African American women. [12][13][14] Such interventions have resulted in limited success.…”

A qualitative analysis of text message conversations in a breastfeeding peer counselling intervention

“…The Lactation Advice Through Texting Can Help (LATCH) intervention is an innovative approach to augment the effectiveness of PCs (Harari et al, ; Martinez‐Brockman et al, ). The LATCH study was a single‐blind, randomized controlled trial that tested the effectiveness of a two‐way text messaging intervention on exclusive breastfeeding in a sample of women attending one of four different WIC clinics in Connecticut and participating in the BFPC program.…”

Impact of the Lactation Advice Through Texting Can Help (LATCH) Trial on Time to First Contact and Exclusive Breastfeeding among WIC Participants

“…The Webbased platform recorded when the messages were sent, whether they were received by the participant, and all message exchanges between participants and their BFPCs. Prenatal and peripartum text messages were developed in English and Spanish during the pilot study, 16 refined and expanded upon with feedback from BFPCs and IBCLCs to cover up to 3 months postpartum for the current study, and sent to participants in their language of preference. Fully consistent with the Loving Support program, message content covered the benefits of BF for mothers and children, showed examples of proper positioning, explained how to tell whether the baby was getting enough milk, debunked BF myths, and reinforced the BFPC's supportive role.…”

“…The LATCH study was a multisite, single-blind RCT built upon a pilot study. 16 It was designed to test the effectiveness of a 2-way text messaging intervention encouraging exclusive BF among women enrolled in WIC, combining in-person prenatal and postpartum BF education and support (BF peer counseling) with mobile health technology (text messaging). The effectiveness of BFPCs was clearly established in the literature [17][18][19][20][21] ; thus, the text messaging intervention was designed to facilitate the BFPCs' work, not replace it.…”