Breast-feeding in a low-income population. Program to increase incidence and duration

Abstract

Objective: To evaluate the efficacy of an intervention program to increase breast-feeding in a low-income, inner-city population.

Design: A randomized, nonblinded clinical control trial. Patients were followed up through pregnancy, delivery, and the first year of the infant's life or until the time of weaning from the breast, whichever came first.

Setting: The ambulatory care center for prenatal and pediatric care and the inpatient maternity unit of a primary care center that serves a low-income, inner-city population.

Patients: There were a total of 108 patients: 51 were randomized to the intervention group that received prenatal and postnatal lactation instruction from a lactation consultant, and 57 were randomized to the control group that received the standard of care at the institution. Patients in the control group were not seen by the lactation consultant. The two groups were similar demographically.

Intervention: This program consisted of individual prenatal lactation consultation, daily rounds by the lactation consultant on the postpartum unit, and outpatient follow-up at 48 hours after discharge, at the time that the infant was 1 week of age, and at all future health supervision visits for infants up to 1 year of age.

Main outcome measures: The incidence and duration of breast-feeding.

Results: There was a markedly higher incidence of breast-feeding in the intervention group, as compared with that of the control group (61% vs 32%, respectively; P = .002). The duration of breast-feeding was also significantly longer in the intervention group (P = .005).

Conclusions: This lactation program increased the incidence and duration of breast-feeding in our low-income cohort. We suggest that similar efforts that are applied to analogous populations may increase the incidence and duration of breast-feeding in low-income populations in the United States.