Black or African American
18%
Source
Peer reviewed?
Yes
Anderson, A. K., Damio, G., Young, S., Chapman, D. J., & Perez-Escamilla, R. (2005). A randomized trial assessing the efficacy of peer counseling on exclusive breastfeeding in a predominantly Latina low-income community. Archives of Pediatrics & Adolescent Medicine, 159(9), 836–841. https://doi.org/10.1001/archpedi.159.9.836
Model(s) Reviewed
Funding Sources
This research was supported by the Centers for Disease Control and Prevention through a subcontract with the Association of Teachers of Preventative Medicine.
Study Design
| Design | Attrition | Baseline equivalence | Confounding factors | Valid, reliable measures? |
|---|---|---|---|---|
| Randomized controlled trial | Low | Not assessed for randomized controlled trials with low attrition |
No |
Yes |
Study Participants
Pregnant women were recruited at prenatal clinics. To be eligible, the mother had to be age 18 or older, up to 32 weeks pregnant, have no medical conditions that could impair successful breastfeeding, and have household earnings below 185 percent of the federal poverty level. At the time of birth, mother-child dyads were screened a final time and deemed eligible for the study if the newborn was born at term and with normal birth weight, no medical complications requiring treatment in the neonatal intensive care unit, and an Apgar score of 6 or higher at one and five minutes after birth. Among eligible mothers, 77 were randomly assigned to the Breastfeeding: Heritage and Pride™ (BHP) home visiting intervention group and 85 to the comparison group. The analytic sample included 135 mother-child dyads, 63 in the BHP group and 72 in the comparison group. Outcomes were measured at birth and at one month, two months, and three months postpartum. Seventy-two percent of mothers were Hispanic, 18 percent were Black, seven percent were Caucasian, and three percent reported they were another race.
Setting
The study took place in Hartford, Connecticut.
Home Visiting Services
The Breastfeeding: Heritage and Pride™ (BHP) intervention consisted of three prenatal home visits, daily in-hospital visits during postpartum hospitalization, and nine postpartum home visits. All visits were conducted by peer counselors, one of whom was assigned to each mother-child dyad. The first prenatal home visit took place within one to two weeks of study enrollment; the second took place before the 36th week of pregnancy, and the third took place during the 36th week. During prenatal home visits, the peer counselor provided education on a range of topics including the benefits of exclusively breastfeeding, reasons for avoiding bottles or pacifiers, behaviors that impede early initiation and successful breastfeeding, infant feeding cues, and proper latch-on technique or positioning. Other members of the family were encouraged to participate in the prenatal visits. During the postpartum period, there were three home visits in the first week postpartum, two in the second week, and one each week from Weeks 3 through 6. The peer counselor provided one-on-one breastfeeding support and counseling based on the mother’s needs.
Comparison Conditions
Mothers assigned to the comparison condition received conventional breastfeeding education at prenatal clinic visits, and one-on-one breastfeeding assistance and education during postpartum hospitalization. If any mothers experienced breastfeeding problems requiring assistance beyond that provided routinely by staff nurses, a hospital lactation consultant on duty provided support to the mother.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Study Participants
Pregnant women were recruited at prenatal clinics. To be eligible, the mother had to be age 18 or older, up to 32 weeks pregnant, have no medical conditions that could impair successful breastfeeding, and have household earnings below 185 percent of the federal poverty level. At the time of birth, mother-child dyads were screened a final time and deemed eligible for the study if the newborn was born at term and with normal birth weight, no medical complications requiring treatment in the neonatal intensive care unit, and an Apgar score of 6 or higher at one and five minutes after birth. Among eligible mothers, 77 were randomly assigned to the Breastfeeding: Heritage and Pride™ (BHP) home visiting intervention group and 85 to the comparison group. The analytic sample included 135 mother-child dyads, 63 in the BHP group and 72 in the comparison group. Outcomes were measured at birth and at one month, two months, and three months postpartum. Seventy-two percent of mothers were Hispanic, 18 percent were Black, seven percent were Caucasian, and three percent reported they were another race.
Setting
The study took place in Hartford, Connecticut.
Home Visiting Services
The Breastfeeding: Heritage and Pride™ (BHP) intervention consisted of three prenatal home visits, daily in-hospital visits during postpartum hospitalization, and nine postpartum home visits. All visits were conducted by peer counselors, one of whom was assigned to each mother-child dyad. The first prenatal home visit took place within one to two weeks of study enrollment; the second took place before the 36th week of pregnancy, and the third took place during the 36th week. During prenatal home visits, the peer counselor provided education on a range of topics including the benefits of exclusively breastfeeding, reasons for avoiding bottles or pacifiers, behaviors that impede early initiation and successful breastfeeding, infant feeding cues, and proper latch-on technique or positioning. Other members of the family were encouraged to participate in the prenatal visits. During the postpartum period, there were three home visits in the first week postpartum, two in the second week, and one each week from Weeks 3 through 6. The peer counselor provided one-on-one breastfeeding support and counseling based on the mother’s needs.
Comparison Conditions
Mothers assigned to the comparison condition received conventional breastfeeding education at prenatal clinic visits, and one-on-one breastfeeding assistance and education during postpartum hospitalization. If any mothers experienced breastfeeding problems requiring assistance beyond that provided routinely by staff nurses, a hospital lactation consultant on duty provided support to the mother.
Were any subgroups examined?
No
Subgroups examined
There were no subgroups reported in this manuscript.
Findings that rate moderate or high in this manuscript
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Non-exclusive breastfeeding |
At hospital discharge |
High | 1.35 | Not statistically significant, p= >0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Not breastfeeding |
3 months old |
High | 1.26 | Not statistically significant, p= >0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (24 hour recall) |
1 month old |
High | 1.41 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (24 hour recall) |
2 months old |
High | 1.34 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (24 hour recall) |
3 months old |
High | 1.33 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (previous week's recall) |
1 month old |
High | 1.38 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (previous week's recall) |
2 months old |
High | 1.29 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (previous week's recall) |
3 months old |
High | 1.30 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (since birth recall) |
1 month old |
High | 1.27 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (since birth recall) |
2 months old |
High | 1.29 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Non-exclusive breastfeeding (since birth recall) |
3 months old |
High | 1.24 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Experiencing 1 or more diarrhea episodes |
3 months old |
High | 2.15 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
||
Breastfeeding not initiated |
At hospital discharge |
High | 2.48 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
| Outcome measure | Timing of follow-up | Rating | Direction of Effect | Effect size (absolute value) | Stastical significance | Sample size | Sample description | |
|---|---|---|---|---|---|---|---|---|
Maternal lactational amenorrhea status |
3 months old |
High | 1.40 | Statistically significant, p= <0.05 |
135 mother/child dyads | BHP and conventional breastfeeding support vs. conventional breastfeeding support RCT, Connecticut, 2003-2004, full sample |
This study included participants with the following characteristics at enrollment:
Race/Ethnicity
Maternal Education
Other Characteristics
This study included participants from the following locations:
- Connecticut