Exclusive breastfeeding--breast milk only--is recommended for babies in the first six months of life. However, among immigrant Latinas, exclusive breastfeeding is rare. Most interventions that have been successful in increasing breastfeeding have involved face-to-face counseling with skilled staff. Less is known about the effectiveness of lower cost strategies. A recent study, published in the Journal of Human Lactation, examined the the impact of a hospital-based breastfeeding clinic (staffed by paraprofessionals) on exclusive breastfeeding and among mixed feeders, amount of formula provided to the babies.
The study, carried out in Texas, involved a randomized design, with mothers and healthy infants being assigned at birth either to an early clinic visit within 3 to 7 days (n=255) or to usual care 2 weeks later (n=267). About 90% of the mothers were immigrants from Latin America. At the clinic, bilingual, trained paraprofessionals provided breastfeeding education and counseling, under the supervision of a certified lactation consultant or registered nurse. Interviewers phoned the women at one month postpartum to determine the number of breast milk, formula, tea, agua de arroz (rice water), or other types of feedings, as well as the amounts of non-milk feeds during the previous 24 hours. The main outcome was the rate of exclusive breastfeeding, defined at breast milk intake alone or with medications and vitamins.
About half of the mothers in the intervention group actually received the follow-up counseling from the clinic within 3 to 7 days. Women who lived closer to the clinic, had more social support, and expressed a desire to breastfeed exclusively were more likely to show-up for their clinic visits. Although breastfeeding problems were common among all women, those in the intervention group reported less breast pain than controls. At one month postpartum, more mothers in the clinic intervention group were exclusively breastfeeding (16.8%), compared to controls (10.4%), p=0.045. Most of the increase seemed to be due to fewer women giving herbal teas and water in the intervention group, compared to controls. Among women who were mixed or combination feeders, those in the intervention group gave less formula per 24 hours (11.7 oz) than in the control group (14 oz), p=0.02. This study is the first to examine the impact of a hospital-based clinic on exclusive breastfeeding rates among immigrant Latinas. Since the hospital had not yet adopted “Baby Friendly” policies, the breastfeeding clinic intervention may have had only limited effects on reducing formula use.
Source: Hopkinson J and Gallagher MK. Assignment to a hospital-based breastfeeding clinic and exclusive breastfeeding among immigrant Hispanic mothers: a randomized, controlled trial. J Hum Lact 2009; 25; 287.
