A breastfeeding education program - Breastfeeding and Prenatal Nutrition Issues

Nutrition Research Newsletter, August, 2002

Breastfeeding provides many benefits for the health, growth, and development of infants. Exclusive breastfeeding increases these benefits. However, few infants in the United States are breastfed beyond 1 to 2 months of age and there is great disparity among racial and economic classes. Women who are a minority, single, poorly educated and participate in the Supplemental Nutrition Program for Women, Infants and Children (WIC) are breastfeeding at the lowest rates, while many of their infants have high rates of morbidity and mortality.

Several variables such as lack of education and support, embarrassment, returning to work or school shortly after delivery and distribution of free formula samples, seem to affect breastfeeding behaviors among WIC participants. Researchers have found that offering small gift items in an incentive program increased breastfeeding rates among WIC participants. Therefore, a recent study published in JADA evaluated whether there will be a greater incidence of breastfeeding at hospital discharge, significantly more mothers who exclusively breastfeed and significantly more breastfeeding at 2 months postpartum in WIC women who receive intensive breastfeeding education and incentives to breastfeed.

Sixty women recruited from an urban WIC program serving a mostly minority population with the highest poverty level in the city were used for this study. Twenty-nine pregnant women were assigned to the control group and 19 to an intervention group. The intervention consisted of breastfeeding education by a trained counselor plus incentive marketing in the form of a truth or myth activity in a small group format. An enhanced food package and extended program eligibility were offered to breastfeeding subjects. In addition, mothers whom exclusively breastfed for at least two months were eligible to receive a $25 mall gift certificate. Women in the control group received the usual prenatal education regarding general benefits and barriers to breastfeeding and both groups were offered education materials and support. Data about knowledge, perceptions, attitudes and breastfeeding intentions of the subjects were obtained before and after the breastfeeding education.

A significant increase in breastfeeding knowledge and benefit perceptions among the intervention group was observed. There were also significant changes in breastfeeding intentions among intervention participants after breastfeeding education. The number of subjects in the control group planning to exclusively breastfeed decreased, while the number in the intervention group significantly increased. Although the percentage of women breastfeeding in the intervention group was greater (79 vs. 69), there was not a significant difference in initiation rates between the two groups. Total duration was not significantly different, but exclusive duration was significantly lower for the intervention group. Most women in the study indicated they valued at least one incentive, but there were no significant differences in the types of incentives chosen, in incentive responses post-intervention or the group responses.

The main findings of this study were the significant positive influence of the intervention on breastfeeding attitudes and perceptions as well as on exclusive breastfeeding initiation and duration. Since exclusive breastfeeding has been shown to result in maximum health benefits and cost savings, these results are noteworthy.

Cristin Finch and Eileen Daniel, Breastfeeding Education Program with Incentives Increases Exclusive Breastfeeding Among Urban WIC Participants, JADA 102(7): 981-984 (July 2002) [Address correspondence to Eileen L. Daniel, Ded, RD, Associate Professor and Chair, Department of Health Science, SUNY College at Brockport, Brockport, NY 14420]