Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: a randomized controlled trial

Arch Pediatr Adolesc Med. 2004 Sep;158(9):897-902. doi: 10.1001/archpedi.158.9.897.


Background: Breastfeeding peer counseling has improved breastfeeding rates in developing countries; however, its impact in this country has not been adequately evaluated.

Objective: To evaluate the effectiveness of an existing, breastfeeding peer counseling program within the United States.

Design: Randomized, prospective, controlled trial in which participants were recruited prenatally and randomly assigned to receive either routine breastfeeding education or routine breastfeeding education plus peer counseling.

Setting: An urban hospital serving a large population of low-income Latinas.

Participants: Pregnant women (< or =26 weeks' gestation) were recruited from the hospital's prenatal clinic. Inclusion criteria specified that participants be low income, be considering breastfeeding, have delivered a healthy, full-term singleton, and have access to a telephone. Intervention Breastfeeding peer counseling services included 1 prenatal home visit, daily perinatal visits, 3 postpartum home visits, and telephone contact as needed.

Main outcome measures: Breastfeeding rates at birth and 1, 3, and 6 months postpartum.

Results: The proportion not initiating breastfeeding was significantly lower in the intervention group than among controls (8/90 [9%] vs 17/75 [23%]; relative risk, 0.39; 95% confidence interval, 0.18-0.86). The probability of stopping breastfeeding also tended to be lower in the intervention group at both 1 month (36% vs 49%; relative risk, 0.72; 95% confidence interval, 0.50-1.05) and 3 months (56% vs 71%; relative risk, 0.78; 95% confidence interval, 0.61-1.00).

Conclusion: These findings demonstrate that, in the United States, peer counselors can significantly improve breastfeeding initiation rates and have an impact on breastfeeding rates at 1 and 3 months post partum.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Breast Feeding / ethnology*
  • Counseling*
  • Female
  • Follow-Up Studies
  • Health Education
  • Health Promotion
  • Hispanic or Latino / ethnology*
  • Humans
  • Maternal Welfare
  • Peer Group*
  • Poverty / ethnology*
  • Program Evaluation
  • Prospective Studies
  • Statistics as Topic
  • United States / ethnology