“Real-world” effect of a peer counselor on breastfeeding outcomes in an urban prenatal clinic in the United States

Abstract

Background One approach for improving breastfeeding support and alleviating breastfeeding disparities is the implementation of a clinic-based peer counselor. Our objective was to assess the “real life” effects of an autonomous peer counselor who provides tailored support to low-income, minority women based on individual needs rather than a pre-determined research protocol. Methods This is a secondary analysis of a prospective cohort study of women receiving publicly funded prenatal care during the 6 months before and after introduction of a peer counselor in a single prenatal clinic. The peer counselor provided one-on-one antenatal and postpartum lactation support. Electronic medical record and survey data were collected. The primary outcome was breastfeeding continuation at 6 weeks postpartum. Secondary outcomes included breastfeeding comfort, confidence, and training satisfaction, any breastfeeding, and total breastfeeding duration. Bivariable and multivariable analyses were performed. Results Peer counselor exposure was not associated with the primary outcome of continued breastfeeding at 6 weeks (55.6% with peer counselor versus 49.1% without; aOR 1.26, 95% CI 0.69–2.31). However, women with peer counselor exposure were more likely to be satisfied with breastfeeding training at the time of delivery (98.2% vs. 83.6%, p = 0.006) and were more likely to have performed any breastfeeding (89.8% vs. 78.9%, p = 0.04), which remained significant on multivariable analysis (aOR 2.85, 95% CI 1.11–7.32). Conclusions Peer counselor interventions are a promising approach to increase breastfeeding initiation. Further research is required to inform the most efficacious approach while also allowing peer counselors to operate independently and in line with the specific needs of their clients.

Reducing Lactation Support Disparities for a Marginalized Community Through a Policy, Systems, and Environmental Change Approach: A Case Study in Michigan

“…In addition, one of the Bangla-speaking peer counselors was mentored by the EMU-CHDIS IBCLC and later was hired for a peer counselor position by the City of Detroit Health Department WIC. The potential positive outcomes of programs similar to ours is supported by the findings of Martinez et al (2020), who documented improved breastfeeding initiation among low-income underserved parents in Chicago, following culturally sensitive, patient-centered education, and counseling provided by breastfeeding peer counselors.…”

Breastfeeding Education: A Scoping Review

“…However, breastfeeding advice from trained peers is also a promising approach to promote exclusive breastfeeding. The results showed that women exposed to peer counselors were more likely to be satisfied with breastfeeding practice at the time of delivery and more likely to breastfeed (43). It also increased the Breastfeeding inisiation (18), duration and exclusivity of breastfeeding (44).…”

Application and Modification of RT-LAMP for Rapid Detection of SARS-CoV-2 Viral Genome

“…Compared to nucleic acid amplification tests (NAATs) like RT-PCR, this method is considered faster and less expensive (42). Nevertheless, there are some evidences suggesting that virus-based IFAs and ELISAs have a high level of sensitivity (85-100%) but with a low degree of specificity (43). COVID-19 serological test is not effective at an early stage of viral infection as the targeted antibodies only produce after several days of infection (44)…”