Sandra McGinnis1, Eunju Lee2, Kristen Kirkland3, Claudia Miranda-Julian3, Rose Greene1. 1. 1 Center for Human Services Research, School of Social Welfare, University at Albany, Albany, NY, USA. 2. 2 School of Social Welfare, University at Albany, Albany, NY, USA. 3. 3 Bureau of Research, Evaluation and Performance Analytics, New York State Office of Children and Family Services, Rensselaer, NY, USA.
Abstract
PURPOSE: To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. DESIGN: A secondary analysis of program data from a statewide home visitation program. SETTING: Thirty-six Healthy Families New York sites across New York State. SUBJECTS: A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. INTERVENTION: Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. MEASURES: Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). ANALYSIS: Logistic regression. RESULTS: Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. CONCLUSIONS: Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.
PURPOSE: To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. DESIGN: A secondary analysis of program data from a statewide home visitation program. SETTING: Thirty-six Healthy Families New York sites across New York State. SUBJECTS: A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. INTERVENTION: Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. MEASURES: Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). ANALYSIS: Logistic regression. RESULTS: Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. CONCLUSIONS: Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.
Entities:
Keywords:
at risk mothers; breastfeeding initiation and continuation; breastfeeding promotion; home visiting; low SES women
Authors: Adam K Lewkowitz; Julia D López; Richard I Stein; Janine S Rhoades; Rosa C Schulz; Candice L Woolfolk; George A Macones; Debra Haire-Joshu; Alison G Cahill Journal: Breastfeed Med Date: 2018-06-18 Impact factor: 1.817