Original Research Well Established Women of lower socioeconomic status and certain minority women are less likely to initiate breastfeeding and to breastfeed exclusively. Use of educational videos prenatally is a potentially cost-effective strategy to promote breastfeeding. Newly ExpressedThis study tested the effectiveness of a breastfeeding education video in the prenatal clinic. The results suggest that an educational video alone is ineffective in improving the hospital breastfeeding practices of low-income women. BackgroundBreastfeeding provides substantial health, psychosocial, economic, and environmental benefits for both infant and mother, and exclusive breastfeeding grants even greater health benefits than partial breastfeeding. Abstract Background: Guidelines recommend prenatal education to improve breastfeeding rates; however, effective educational interventions targeted at low-income, minority populations are needed as they remain less likely to breastfeed. Objective: To determine whether a low-cost prenatal education video improves hospital rates of breastfeeding initiation and exclusivity in a low-income population. Methods: A total of 522 low-income women were randomized during a prenatal care visit occurring in the third trimester to view an educational video on either breastfeeding or prenatal nutrition and exercise. Using multivariable analyses, breastfeeding initiation rates and exclusivity during the hospital stay were compared. Results: Exposure to the intervention did not affect breastfeeding initiation rates or duration during the hospital stay. The lack of an effect on breastfeeding initiation persisted even after controlling for partner, parent, or other living at home and infant complications (adjusted odds ratio [OR] = 1.05, 95% CI, 0.70-1.56). In addition, breastfeeding exclusivity rates during the hospital stay did not differ between the groups (P = .87). Conclusion: This study suggests that an educational breastfeeding video alone is ineffective in improving the hospital breastfeeding practices of low-income women. Increasing breastfeeding rates in this at-risk population likely requires a multipronged effort begun early in pregnancy or preconception.

The low prevalence of baby bottle images on commonly purchased baby gift and baby shower items is encouraging. However, the absence of breastfeeding images and the relatively high prevalence of baby dolls marketed with a baby bottle demonstrate that breastfeeding is not portrayed as the physiologic norm on these products. Product designers should explore ways to promote breastfeeding, consumers should make informed choices in product selection, and advocacy groups should promote guidelines for these products.