The effect of peer Counselors on Breastfeeding rates in the neonatal intensive care unit - Results of a randomized controlled trial

Objective: To determine whether peer counselors impacted breastfeeding duration among premature infants in an urban population. Design: This was a randomized controlled clinical trial. Setting: The trial was conducted in the Newborn Intensive Care Unit at Boston Medical Center, an inner-city teaching hospital with approximately 2000 births per year. Participants: One hundred eight mother-infant pairs were enrolled between 2001 and 2004. Pairs were eligible if the mother intended and was eligible to breast-feed per the 1997 guidelines from the American Academy of Pediatrics and if the infant was 26 to 37 weeks' gestational age and otherwise healthy. Intervention: Subjects were randomized to either a peer counselor who saw the mother weekly for 6 weeks or to standard of care. Main Outcome Measure: The main outcome measure was any breast-milk feeding at 12 weeks postpartum. Results: Intervention and control groups were similar on all measured sociodemographic factors. The average gestational age of infants was 32 weeks ( range, 26.3-37 weeks) with a mean birth weight of 1875 g ( range, 6823005 g). At 12 weeks postpartum, women with a peer counselor had odds of providing any amount of breast milk 181% greater than women without a peer counselor ( odds ratio, 2.81 [ 95% confidence interval, 1.11-7.14]; P=.01). Conclusions: Peer counselors increased breastfeeding duration among premature infants born in an inner-city hospital and admitted to the neonatal intensive care unit. Peer counseling programs can help to increase breastfeeding in this vulnerable population.