BREAST-FEEDING IN A LOW-INCOME POPULATION - PROGRAM TO INCREASE INCIDENCE AND DURATION

Objective: To evaluate the efficacy of an intervention program to incr ease breast-feeding in a low-income, inner-city population. Design: A randomized, nonblinded clinical control trial. Patients were followed up through pregnancy, delivery, and the first year of the infant's lif e or until the time of weaning from the breast, whichever came first. Setting: The ambulatory care center for prenatal and pediatric care an d the inpatient maternity unit of a primary care center that serves a low-income, inner-city population. Patients: There were a total of 108 patients: 51 were randomized to the intervention group that received prenatal and postnatal lactation instruction from a lactation consulta nt, and 57 were randomized to the control group that received the stan dard of care at the institution. Patients in the control group were no t seen by the lactation consultant. The two groups were similar demogr aphically. Intervention: This program consisted of individual prenatal lactation consultation, daily rounds by the lactation consultant on t he postpartum unit, and outpatient follow-up at 48 hours after dischar ge, at the time that the infant was 1 week of age, and at all future h ealth supervision visits for infants up to 1 year of age. Main Outcome Measures: The incidence and duration of breast-feeding. Results: Ther e was a markedly higher incidence of breastfeeding in the intervention group, as compared with that of the control group (61% vs 32%, respec tively; P=.002). The duration of breast-feeding was also significantly longer in the intervention group (P=.005). Conclusions: This lactatio n program increased the incidence and duration of breast-feeding in ou r low-income cohort. We suggest that similar efforts that are applied to analogous populations may increase the incidence and duration of br east-feeding in low-income populations in the United States.