Breastfeeding Outcomes in Washington State: Determining the Effect of Loving Support Peer Counseling Program and Characteristics of Participants at WIC Agencies

Abstract

Objective: Determining the effect of the Loving Support Peer Counseling Program (LSPCP), and characteristics of participants on breastfeeding (BF) outcomes at Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) agencies in Washington State.

Design: Nonrandomized treatment vs control.

Setting: Public Health-Seattle and King County (PHSKC), Catholic Health Initiatives Franciscan Medical Group (CHIFMG).

Participants: Women enrolled in WIC (intervention: PHSKC, n = 15,290; CHIFMG, n = 3,582).

Interventions: Clinics with a LSPCP.

Main outcome measures: BF initiation and BF duration of all infants who turned 8 months old during the reported period.

Analysis: Two-tailed binomial test and tree-based regression.

Results: Both PHSKC and CHIFMG clinics with a LSPCP expressed significant (P < .001) improvement in BF initiation and BF duration for >6 months. The likelihood that women enrolled in WIC would initiate BF at PHSKC clinics increased by 3%, whereas those in CHIFMG clinics increased by 6.8%. Women receiving services in smaller PHSKC clinics (n < 60 women) were likely to breastfeed their infants at >1 week. The proportionalities of non-Hispanic and black participants in PHSKC clinics were the primary and secondary predictors of the likelihood of BF discontinuing between 7 and 28 days' duration. In addition, clinics serving participants who spoke Tigrigna had increased rates of BF for a minimum of 6 months.

Conclusions and implications: Findings may be used to reevaluate funding allocations, secure grants to reduce program constraints to stabilize LSPCP, develop strategies to reduce BF cessation at larger clinics, and improve peer counseling and other BF support to black and non-Hispanic women in the early postpartum period. The findings contribute to the study of the effects of LSPCP on BF initiation and duration while furthering a scholarly understanding of the way in which the WIC program interacts with participant characteristics at 2 local WIC agencies in Washington State.

Keywords: WIC; breastfeeding; peer counseling program; tree-based regression.