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Randomized Controlled Trial
. 2014 Mar;210(3):239.e1-5.
doi: 10.1016/j.ajog.2013.11.028. Epub 2013 Nov 18.

An intervention to extend breastfeeding among black and Latina mothers after delivery

Elizabeth A Howell  1 , Susan Bodnar-Deren  2 , Amy Balbierz  3 , Michael Parides  3 , Nina Bickell  4
Affiliations
Randomized Controlled Trial

An intervention to extend breastfeeding among black and Latina mothers after delivery

Elizabeth A Howell et al. Am J Obstet Gynecol. 2014 Mar.

Abstract

Objective: The purpose of this study was to compare breastfeeding duration in mothers after delivery who were assigned randomly to a behavioral educational intervention vs enhanced usual care.

Study design: We conducted a randomized trial. Self-identified black and Latina mothers early after delivery were assigned randomly to receive a behavioral educational intervention or enhanced usual care. The 2-step intervention aimed to prepare and educate mothers about postpartum symptoms and experiences (including tips on breastfeeding and breast/nipple pain) and to bolster social support and self-management skills. Enhanced usual care participants received a list of community resources and received a 2-week control call. Intention-to-treat analyses examined breastfeeding duration (measured in weeks) for up to 6 months of observation. This study was registered with clinicaltrial.gov (NCT01312883).

Results: Five hundred forty mothers were assigned randomly to the intervention (n = 270) vs control subjects (n = 270). Mean age was 28 years (range, 18-46 years); 62% of the women were Latina, and 38% were black. Baseline sociodemographic, clinical, psychosocial, and breastfeeding characteristics were similar among intervention vs control subjects. Mothers in the intervention arm breastfed for a longer duration than did the control subjects (median, 12.0 vs 6.5 weeks, respectively; P = .02) Mothers in the intervention arm were less likely to quit breastfeeding over the first 6 months after delivery (hazard ratio, 0.79; 95% confidence interval, 0.65-0.97).

Conclusion: A behavioral educational intervention increased breastfeeding duration among low-income, self-identified black and Latina mothers during the 6-month postpartum period.

Keywords: breastfeeding; intervention; minority; postpartum; randomized trial.

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Figures

Figure 1
Figure 1
Participants’ flow through study* *Howell EA, Balbierz A, Wang J, Parides M, Zlotnick C, Leventhal H. Reducing postpartum depressive symptoms among black and Latina mothers: a randomized controlled trial. Obstet Gynecol. May 2012;119(5):942–949.
Figure 2
Figure 2
Breastfeeding duration for intervention versus control.
See this image and copyright information in PMC

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