Peer Counseling Intervention to Enhance Breastfeeding in Low-Income Infant-Mother Dyads in Central Kentucky

The goal of this study is to pilot test a community-based intervention to increase breastfeeding initiation, duration, and exclusivity in low-income infant-mother dyads in Central Kentucky. Kentucky has a higher birth rate among women in poverty compared with the nation (Kentucky 33%, National 28%), and also a higher rate of first time mothers aged 15 to 22, (Kentucky 5.6%, National 4.2%), which implies limited or no experience in breastfeeding. This could be one of the reasons Kentucky has among the lowest rates of breastfeeding nationwide (Kentucky 61%, National 79%). During this study, we will test a community-based peer counseling breastfeeding support program to enhance initiation, duration, and exclusivity of breastfeeding. Breastfeeding peer counselors (PCs), who are local community women who have successfully breastfed, will receive training in breastfeeding education and will work with their peers to improve breastfeeding outcomes. The PCs will be trained and supervised by Dr. Linares, an International Board Certified Lactation Consultant (IBCLC). An intervention consisting of 2 prenatal visits, 1 in-hospital visit, 3 home postpartum visits, and free phone calls will be conducted. The intervention is designed to: 1) raising consciousness—through seeking and processing awareness of benefits of adopting exclusive breastfeeding for 6 months and delaying introduction of solid food; 2) anticipating barriers to breastfeed; and 3) promoting self-efficacy. The result of this PC-led intervention on breastfeeding initiation, duration and exclusivity will be compared with a usual care group that will receive traditional prenatal care. Observed effect sizes in this pilot project will be used to inform a future randomized clinical trial. Key Words: Breastfeeding, Peer Counseling, Lactation Consultant, Kentucky