Submitted to: International Society for Research on Human Milk and Lactation
Publication Type: Abstract Only
Publication Acceptance Date: 5/1/2000
Publication Date: 1/1/2002
Citation: Hopkinson, J., Smith, O.E., Acosta, R., Handal, D., Lopez, S., Butte, N.F., Rourke, J. 2002. Postpartum home visits increase duration of exclusive among inexperienced breastfeeding women. In: Davis, M.K., Isaacs, C.E., Hanson, L.A., Wright, A.L. (Editors). Integrating Population Outcomes, Biological Mechanisms and Research Methods in the Study of Human Milk and Lactation. New York, NY. Kluwer Academic Publishers. p. 271-272. Interpretive Summary: Not required for meeting proceedings.
Technical Abstract: Exclusive breastfeeding is recommended but uncommon in the United States. We undertook a randomized study of the efficacy of telephone consultation (T) and home visits (H) to increase the duration of exclusive breastfeeding among low-income Hispanic women in Houston, Texas. At project initiation, WIC breastfeeding rates were 43% with <1% exclusive breastfeeding. Data collected retrospectively from 105 accompanied by children under 12 months of age attending well child visits at the local health clinic indicated that at 3 months postpartum 42% were breastfeeding and 6% were breastfeeding exclusively. The pre-intervention control group (PC) consisted of a subset of twenty of those interviewed who matched the intervention group for sites of delivery and prenatal care, zip code, parity, maternal age, and singleton, term, healthy infant at birth. Of these, 8 (40%) were breastfeeding at 3 months and 1 (5) was breastfeeding exclusively at 3 months. A concurrent control group (CC) was selected from women interviewed six months after initiating the intervention study. Nineteen women met the demographic criteria listed above and delivered the index child within the previous 6 months. Rates of breastfeeding (52% and exclusive breastfeeding (10%) at 3 months in the CC groups did not differ significantly from those in the PC group. Therefore, data were combined for analyses. The intervention groups of 121 mothers of healthy, singleton, and term infants were enrolled in hospital. Mothers were assisted with breastfeeding in hospital and assigned to home-visit (H) (n=63) or telephone consultation (T) (n-58) groups by random number table after discharge. There were no differences between intervention and control groups for site of delivery, prenatal care, zip code, parity, birth weight or age. Introduction of routine supplements was examined by Cox regression analysis. Both H and T groups withheld supplements for a longer time than controls (p<0.003) There was an interaction between group and prior breastfeeding (p<0.01) such that home visits were more effective than phone calls for inexperienced women (p<0.001), but not for experienced breast feeders. At 3 months, 80% of study participants were breastfeeding, and 38% were breastfeeding exclusively. In conclusion, home visits by experienced breastfeeding counselors aid in the acquisition of critical breastfeeding skills. Once breastfeeding skills are acquired, telephone consultation and home visits are equally effective methods for increasing the duration of exclusive breastfeeding with subsequent children.