Impact of Lactation Consultant and Peer Counselor Team Interventions on Exclusive Breastfeeding Rates among Adolescent Mothers

Wednesday, 9 July 2008: 11:10 AM
Wilaiporn Rojjanasrirat, PhD, RNC, IBCLC , School of Nursing, University of Kansas, Kansas City, KS
Karen A. Wambach, PhD, RN , School of Nursing, University of Kansas Medical Center, Kansas City, KS
Hung-Wen Yeh, PhD , School of Medicine, University of Kansas, Kansas City, KS

Learning Objective 1: Describe the components of the interventions used in the clinical trial.

Learning Objective 2: Describe the impact of interventions on exclusive breastfeeding rates among adolescent mothers.

The purpose of this sub-analysis was to assess the impact of interventions of a lactation consultant and peer counselor team on exclusive breastfeeding rates among adolescent mothers enrolled in a RCT to promote and support breastfeeding decision-making, initiation and duration. The theory of planned behavior and adolescent decision-making theoretical principles guided the study.

Pregnant adolescents (N=315), ages 15-18, were recruited from multiple urban prenatal clinics and school settings in the Midwest, US and randomly assigned to an experimental and two control groups. A lactation consultant-peer counselor team was used to influence pregnant adolescents' prenatal beliefs and intentions to breastfeed and to support maintenance of breastfeeding through four weeks postpartum. Breastfeeding rates were collected at hospital discharge, three weeks, six weeks, three months, and six months postpartum. Logistic regression and survival analysis were used to determine the impact of interventions and association between theoretical variables and exclusive breastfeeding.

The overall breastfeeding initiation rate was 69.5% (n = 201) across all study groups. Primary results of the RCT indicated the initiation of breastfeeding in the experimental group was significantly higher than the two control groups (P < 0.05) and breastfeeding duration was longer (P < 0.001). For this sub-analysis the experimental group subjects exhibited a greater likelihood of exclusive breastfeeding compared to control group subjects from hospital discharge to six months, but differences were not statistically significance. Log-rank tests also revealed non-significant differences between groups in the duration of exclusive breastfeeding.

Although the intervention enhanced the initiation and continuation of overall breastfeeding, low power due to decreasing numbers of breastfeeding subjects over time prohibited us from finding significant differences in exclusive breastfeeding rates. Determining the effectiveness of more intense breastfeeding education and support during the first few weeks postpartum on exclusive breastfeeding is needed and requires further investigation in a larger study.