Recent comparisons of growth curves and incidence of low birth weight are available for Caucasians and African-Americans or Hispanics. To compare size at birth in Hispanics with African-Americans in an inner-city population, we analyzed data on mother-infant pairs admitted to Jacobi Medical Center from January 1, 1995 until May 31, 1997 and those with a gestational age less than 34 weeks admitted from June 1, 1997 until December 31, 1997. The population mostly included mothers covered by Medicaid. The study sample included 2852 infants (1641 Hispanics and 1211 African-Americans). Among singletons, the incidence of teenage pregnancy was higher and those of premature delivery and low birth weight were lower in Hispanics than in African-Americans. Among full-term singletons, boys were heavier than girls (difference 116 g, confidence interval (CI) 57,174, p < 0.001 after adjusting for gestational age, gender, and teenage pregnancy), and Hispanics were heavier than African-Americans (adjusted difference 70 g, Confidence Interval (CI) 11,128, p = 0.019). Additional studies are needed to assess the effect of race on neonatal size after adjusting for differences in prepregnancy weight, weight gain, parity, social class, or other factors.

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OBJECTIVE:We hypothesized that the cost of a lactation program can be reduced without significantly affecting the incidence of breastfeeding. STUDY DESIGN:We conducted a retrospective analysis of breastfeeding among all 7942 mothers whose neonates were admitted to the well baby nursery at Jacobi Medical Center (JMC) over a 44-month period We used multiway frequency analysis to compare the incidence of breastfeeding in three successive models of counseling: (1) full-time lactation coordinator, (2) obstetric personnel trained in breastfeeding counseling and full-time lactation coordinator, and (3) obstetric personnel and half-time lactation coordinator. Mothers were further classified into three groups according to location of prenatal care and attendance at breastfeeding education sessions. RESULTS:Breastfeeding increased with the initiation of education and the involvement of obstetric personnel and did not significantly decrease when the lactation coordinator became half-time. The transition to model 3 resulted in decreased costs without significantly affecting the incidence of breastfeeding. Breastfeeding was significantly associated with counseling by obstetric personnel, with prenatal care at JMC, and with breastfeeding education sessions. CONCLUSION:Involving obstetric personnel in breastfeeding counseling may enhance the effectiveness of a lactation program. In our population, the most cost-conscious model included counseling by trained obstetric personnel and a half-time lactation coordinator.Studies have shown that maternal education and counseling programs increase the incidence and duration of breastfeeding in low-income populations.