Breastfeeding rates among mothers in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower than for other mothers in the United States. The objective of this study was to test the acceptability and feasibility of the Lactation Advice thru Texting Can Help intervention. Mothers were enrolled at 18-30 weeks gestation from two WIC breastfeeding peer counselling (PC) programmes if they intended to breastfeed and had unlimited text messaging, more than fifth-grade literacy level, and fluency in English or Spanish. Participants were randomized to the control arm (PC support without texting) or the intervention arm (PC support with texting). The two-way texting intervention provided breastfeeding education and support from peer counsellors. Primary outcomes included early post-partum (PP) contact and exclusive breastfeeding (EBF) rates at 2 weeks PP. Feasibility outcomes included text messaging engagement and mother's satisfaction with texting platform. Fifty-eight women were enrolled, 52 of whom were available for intention-to-treat analysis (n = 30 texting, n = 22 control). Contact between mothers and PCs within 48 hr of delivery was greater in the texting group (86.6% vs.27.3%, p < .001). EBF rates at 2 weeks PP among participants in the texting intervention was 50% versus 31.8% in the control arm (p = .197). Intervention group mothers tended to be more likely to meet their breastfeeding goals (p = .06). Participants were highly satisfied with the Lactation Advice thru Texting Can Help intervention, and findings suggest that it may improve early post-delivery contact and increase EBF rates among mothers enrolled in WIC who receive PC. A large, multicentre trial is feasible and warranted. KEYWORDS breastfeeding, breastfeeding support, infant, low income, peer support, newborn feeding behaviours
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) breastfeeding peer counselling (BFPC) program supports optimal early life nutrition by providing evidenced‐based breastfeeding protection, promotion, and support. The Lactation Advice Through Texting Can Help (LATCH) study was a randomized controlled trial that tested the effectiveness of a text messaging intervention designed to augment the BFPC program. The purpose of the present study was to understand the topics discussed during the text message exchanges between breastfeeding peer counsellors (PCs) and their clients in the intervention arm of the LATCH study, from the time of enrollment up to two‐weeks postpartum. Text messaging data were first coded and analysed for one‐ and two‐way text message exchanges. Text messages of participants with a high volume of two‐way exchanges were then analysed qualitatively. Four domains were identified in both the prenatal and postpartum periods: the mechanics of breastfeeding, social support, baby's nutrition, and PCs maintaining contact with participants. Additional themes and subthemes identified in the postpartum period included the discussion of breastfeeding problems such as latching trouble engorgement, plugged ducts, pumping, other breastfeeding complications, and resuming breastfeeding if stopped. Two‐way text messaging in the context of the WIC BFPC program provides an immediate and effective method of substantive communication between mothers and their PC.
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