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PubMed2005

Early discharge from obstetrics-pediatrics at the Hospital de Valme, with domiciliary follow-up.

OBJECTIVES: This study was undertaken to evaluate the advantages and disadvantages of a program of early obstetric-pediatric discharge (24 hours postpartum) with domiciliary follow-up, compared with the traditional postpartum hospital stay (more than 48 hours), according to the criteria described by reviewers of the subject. STUDY DESIGN: A randomized controlled trial of early obstetric discharge for healthy mothers and term infants, with postpartum randomization, with no prenatal preparation and with observational and clinical follow-up was performed. The participants were mothers with healthy, term neonates (37-42 weeks) weighing more than 2500 g and produced via vaginal delivery and with a verified normal evolution before discharge. The sample consisted of 430 cases (213 cases with early discharge, and 217 control cases) in which the following variables were evaluated: existence of complications in the mother and/or child that required rehospitalization or a medical consultation, existence of maternal problems of fatigue or anxiety/depression after the birth, continuity of lactation and its problems, satisfaction of the mother and family, and relative costs. CONCLUSION: After demonstrating the homogeneity of the groups, no significant differences were found in the rates of maternal rehospitalization (1.9% in the early discharge group vs 2.3% in the control group, relative risk 0.81, 95% CI 0.21-3.03) or in the rates of rehospitalization of the neonates (1.4% in the early discharge group vs 2.3% in the control group, relative risk 0.16, 95% CI 0.15-2.56). No increases were observed in maternal or neonatal disease, puerperal fatigue, or maternal anxiety/depression. A prolongation of maternal lactation to 3 months was observed in the early discharge group (P=.016 <.05 Fisher exact test). When the cost of early discharge is compared with that of traditional discharge with a minimum of 48 hours hospital stay, we find a saving of 18% to 20%. The level of maternal satisfaction with early discharge is better than 90%.

Adult↗
PubMed2004

Parenting knowledge among substance abusing women in treatment.

The purpose of this study was to assess parenting knowledge and beliefs among drug abusing pregnant and recently postpartum women engaged in a comprehensive substance abuse treatment program. The effects of a parenting skills training program for this population were evaluated. A Parenting Skills Questionnaire was developed and administered to a sample of 73 pregnant and drug-dependent women during their first week of substance abuse treatment and again approximately 7 weeks later, following parenting skills training. The questionnaire was designed to assess whether group and individual parenting sessions changed the subjects' knowledge and beliefs in four parenting domains: newborn care, feeding practices, child development and drug abuse during pregnancy. Pre-intervention scores for all parenting domains were low. Post- vs. pre-intervention comparisons showed significant increases in all domain scores after individual and group parenting skills training. Preliminary results obtained from this clinic-based sample suggest that these substance abusing mothers lacked important parenting knowledge and that this knowledge improved after comprehensive substance abuse treatment that included parenting training.

Adult↗
PubMed2006

Country development and the association between parity and overweight.

INTRODUCTION: Parity is associated with overweight and obesity in developed countries and has been related to maternal depletion in poor developing countries. However, the literature from developing countries is limited and may not represent current stages of development. METHODS: We analyzed data from 50 Demographic and Reproductive Health Surveys conducted between 1992 and 2003. We examined the association between parity (proxied by number of live births) and overweight (body mass index (BMI)> or =25 kg/m(2)) in relation to level of country wealth and development. RESULTS: The odds ratio (OR) for overweight comparing women with at least four live births to women with one live birth was >1.0 in 38 of the 50 countries studied. The median OR was >1.0 in all regions studied and highest in North Africa/West Asia, where all countries had OR >1.0. Country wealth and development were both positively associated with the ORs. CONCLUSIONS: The importance of parity as a predictor of overweight increases with national economic development and wealth. Policy implications might include the development and implementation of programs to prevent excessive gestational weight gain and promote postpartum weight loss via dietary change and physical activity, concomitant with exclusive breastfeeding.

Adolescent↗
PubMed2000

Georgia's breastfeeding promotion program for low-income women.

OBJECTIVE: Beginning in 1990, Georgia's Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) initiated 5 new strategies to promote breastfeeding among its pregnant and postpartum clients. These strategies were implemented in 1991, each to be provided as an addition to its standard program of counseling on breastfeeding and distributing appropriate literature: 1) enhanced breastfeeding education, 2) breast pump loans, 3) hospital-based programs, 4) peer counseling, and 5) community coalitions. The enhanced breastfeeding education strategy provides access to a hotline as well as periodic training of staff, and the breast pump loan provides free breast pumps to mothers who want to use them. The hospital-based strategy provides bedside support and counseling to women who have just given birth and includes staff training, as well as a hotline number for women to call after they leave the hospital. The peer-counseling strategy focuses on identifying former WIC participants who have successfully breastfed their infants; these women are recruited to provide support and encouragement to current WIC participants. Finally, the community coalitions approach is designed to identify existing community attitudes about breastfeeding, establish plans to address gaps in breastfeeding services, to develop resource guides on breastfeeding for the community, and to advocate at the community level to support breastfeeding women. The objective of our research was to evaluate the impact of breastfeeding promotion strategies on breastfeeding initiation among WIC participants in Georgia. METHODS: Using data from the Pregnancy Nutrition Surveillance System (PNSS) for 1992-1996, we examined breastfeeding initiation rate during this period and compared rates among 6 different intervention strategies. Also, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) to assess breastfeeding initiation and duration among WIC enrollees. We conducted 13 focus groups to understand the experiences of program participants. Ten focus groups were conducted with women who were breastfeeding their infants, 3 each with women from the community coalitions, hospital-based programs, and standard education programs, and 1 with women from the breast pump loan program. Three focus groups were conducted with women who were feeding their infants formula. RESULTS: PNSS data show that breastfeeding initiation increased in the Georgia WIC program from 31.6% in 1992 to 39.5% in 1996. PRAMS data confirmed the increase in breastfeeding initiation from 33.6% (standard error [SE]: 2.2) in 1993 to 42.1% (SE: 2.4) in 1996 among WIC participants. Both datasets (PRAMS and PNSS) showed breastfeeding initiation to be well below the year 2000 goal of 75%. Overall, PRAMS data show a high breastfeeding initiation among non-WIC participants (range: 64.7% [SE: 2.2]) for 1994 to 70.1% (SE: 2.2) in 1996. The percent change between 1993 and 1996 was 8% for non-WIC participants, and it was 25% for the WIC participants among those responding to the PRAMS questionnaire. Data from PRAMS indicated no statistical change in the percentage of WIC enrollees who breastfed their infants for 8 weeks or more; this estimate was 18.3% (95% confidence interval (CI): 14.9-21.8) in 1993 and 19.4% (95% CI: 15.7-23.2) in 1996, well below the Healthy People 2000 objective of 50% at 6 months. According to PNSS data, the largest increases in breastfeeding initiation for 1992 to 1996 were among younger women (</=19 and 20-24 years old), those with no college (less than high school and high school only), unmarried, and black women (see Table 1). The smallest increases during this period were among older women (30+), those with more than a high school education, and women who were white, Hispanic, or from other ethnic or racial groups. The PRAMS data (1993-1996) generally display similar results, but the pattern by marital status demonstrated larger increases for married women than for unmarried women.

Breast Feeding↗
PubMed1996

Altered glomerular permselectivity to neutral dextrans and heteroporous membrane modeling in human pregnancy.

Hyperfiltration precedes renal function loss in several nephropathies. Animal studies suggest this may be due to accompanying increases in transglomerular capillary hydrostatic pressure difference (delta P) and/or altered glomerular processing of macromolecules. Renal hemodynamics increase strikingly in human pregnancy. To test the hypothesis that these alterations are not potentially harmful, clearances of inulin, p-aminohippurate, and neutral dextrans were measured at 16- and 36-wk gestation, then 4 mo postpartum, in 11 normotensive women. Results were analyzed using two computer modeling programs. Glomerular filtration rate and renal plasma flow (RPF) were markedly elevated in early and late pregnancy (135 +/- 6 and 895 +/- 53 and 135 +/- 6 and 754 +/- 32 ml/min, respectively, vs. 87 +/- 7 and 520 +/- 17 ml/min postpartum). Gestational hyperfiltration was primarily due to RPF increments with a minor contribution from decrements in capillary oncotic pressure. Fractional dextran clearances (particularly the smaller dextrans, 30-39 A radii) were lower in early pregnancy, decreasing further in late pregnancy. There was no evidence of increased delta P and alterations in glomerular membrane porosity resolved postpartum. These data provide a database by which to study effects of pregnancy on chronic renal disease.

Adult↗
PubMed2005

Building a residential treatment program for dually diagnosed women with their children.

The epidemic of drug and alcohol abuse in our nation impacts millions of women, mothers, and children. Addicted mothers with complex problems and numerous co-morbidities present unique treatment challenges. This intergenerational cycle of abuse and addiction is difficult to stop. Arkansas CARES (Center for Addictions Research Education and Services, referred to in this article as CARES) initially was created to treat addicted pregnant and postpartum women and their infants. CARES evolved into a residential treatment program for dually diagnosed mothers with their children. This paper is a synopsis of a presentation delivered at the North American Society for Psychosocial Obstetrics and Gynecology. It shares a glimpse inside the treatment program and lessons learned along the way in an effort to assist others who are interested in building treatment programs for addicted women with their children.

Adult↗
PubMed1990

Ultrasonic identification of follicular populations and return to estrus in early postpartum dairy cows given intravaginal progesterone for 15 days.

In an attempt to program ovarian function in the early post partum period, 52 lactating Holstein cows were injected with 25 mg prostaglandin F(2 alpha) (PGF) and given a CIDR device containing 1.9 g progesterone for 15 d starting on Day 25 post partum. Ovarian follicles were measured by ultrasound on 0, 5, 10 and 15 d after insertion and on alternate days after CIDR removal until estrus. Not all cows were devoid of corpora lutea (CL) during the CIDR (11, 9 and 8 cows had a CL on Days 5, 10 and 15, respectively). There was a CL by day interaction (P<0.01) for the number of 10- to 15-mm follicles per cow; the average number of large follicles (>15 mm) was twice greater (0.75 vs 0.37) for those cows not having a CL during the period of CIDR exposure. The average size of the largest follicle increased to a maximum of 19.3 +/- 0.7 mm by 15 d after insertion in cows not having a CL. Plasma estradiol increased for 10 d after insertion, then decreased to the end of the CIDR period. After removal of the CIDR, 34 cows ovulated, eight cows developed ovarian follicular cysts, and eight cows did not ovulated by 14 d. Cows becoming cystic or not ovulating had a declining number of follicles during the CIDR compared with those cows ovulating (P<0.07). The diameter of the largest follicle in cystic cows was equivalent to noncystic cows until removal of the CIDR, but then it increased markedly. Interval to estrus was longer in cows having more 6- to 9-mm follicles on Day 15 (day of CIDR removal). These results demonstrate the existence and maintenance of a large dominant follicle after CIDR insertion and PGF injection which was influenced apparently by the presence of a CL. Furthermore, subsequent reproductive responses after the CIDR treatment was a function of follicular populations prior to withdrawal of the CIDR device. This system may be appropriate for the study of factors regulating follicular growth and fertility in domestic cattle.

Journal Article↗
PubMedDate not supplied

Prenatal and postpartum care in Hawaii: a community-based approach.

Given the problems of access, retention, and relevant prenatal care content, supplements to existing programs for health-care delivery during pregnancy and after birth are necessary. This article describes a community-based approach to prenatal and postpartum care that has been developed to address these issues. Culturally sensitive strategies were created for use with Hawaiian, Filipino, and Japanese women living on the island of Hawaii. Six nursing care and community outreach interventions were used. Local public health nurses assisted in developing the program and are responsible for its coordination and implementation.

Community Participation↗
PubMedDate not supplied

Doula birth support for incarcerated pregnant women.

The objective of this study was to provide trained labor support (doulas) to pregnant women in jail. A multiagency intervention project provided doula birth services to pregnant women in urban jails. Program evaluation included interviews with women and written satisfaction surveys of providers and correctional officers. A convenience sample of 18 incarcerated women received doula services. A doula visited each woman in jail antepartum to review expectations for labor and birth; during hospitalization, the doula provided continuous support throughout labor and birth. Doulas visited women postpartum to review birth events. Surveys administered to providers and officers demonstrated high satisfaction with the program. Qualitative interviews with 14 women indicated unanimous support for the services and documented women's major concerns. Findings support offering doula services to all pregnant women in custody and expanding doula services to include early and comprehensive intervention coordinated by nurses.

Female↗
PubMed1990

Impact of the Special Supplemental Food Program on infants.

The Special Supplemental Food Program for Women, Infants, and Children, popularly known as WIC, provides participants with supplemental foods and nutrition education. The WIC participants are eligible pregnant, postpartum, and breast-feeding women, infants, and children up to their fifth birthday. The program currently serves 1.2 million infants each month. The U.S. Department of Agriculture National WIC Evaluation Study of Infants and Children is the most comprehensive assessment of WIC's impact on a national infant sample. Its findings indicate that WIC infants consumed more iron-fortified infant formula (the core of the WIC infant food package) than non-WIC infants and, as a result, had higher daily intakes of formula-related nutrients--namely, iron and vitamin C. Because of lower consumption of whole cow milk, WIC infants had lower daily intakes of milk-related nutrients--calcium, protein, magnesium, and vitamin B6. The research team concluded that increased dietary intake of specific nutrients occurs only during program participation and has no residual effect after participation ceases. Possible scientific and social science research that would be useful in federal policy decisions affecting infant participation in the WIC program is discussed.

Child, Preschool↗
PubMed1995

Association between postpartum substance use and depressive symptoms, stress, and social support in adolescent mothers.

OBJECTIVE: Substance use by pregnant teenagers is an important public health problem, but published data on alcohol and illicit drug use by parenting teenagers are virtually nonexistent. This study determined the prevalence of alcohol and drug use in adolescent mothers in the first 4 months postpartum and explored associated psychosocial characteristics. METHODS: Teenagers attending a comprehensive adolescent pregnancy and parenting program were enrolled consecutively during a routine third trimester prenatal visit. Alcohol use since delivery was determined by self-report at 4 months postpartum using an instrument developed for the 1984 Survey of Drug Abuse Among Maryland Adolescents. Illicit drug use was measured with anonymous quantitative urine drug screens at 2 and 4 months postpartum. Depressive symptoms, stress, and social support were assessed at 2 and 4 months postpartum using validated, self-administered instruments. Differences in demographic characteristics, peer group influences, and psychosocial variables between substance users and nonusers were evaluated. RESULTS: Participants (125/129 eligible) were predominantly African-American, mean age 16.3 years. Completed assessments were obtained from 110 at 2 months and 105 at 4 months postpartum. Forty-two percent screened positive for illicit drugs at a postpartum visit or reported using alcohol since delivering their baby and were classified as substance users. Thirty-one percent of subjects reported alcohol use since delivery. Marijuana was the most prevalent illicit drug (14%), followed by opiates (5%), and cocaine (4%). When substance users were compared with nonusers, 44% versus 24% scored depressed (P = .02), 62% versus 43% had high stress (P = .04), and 62% versus 44% reported a high need for social support (P = .07). Results of logistic regression, after controlling for age, indicated that illicit substance and/or alcohol use was 3.3 times greater for those who were depressed, 2.8 times greater if they reported friends' using illicit drugs, and 6.7 times greater if the adolescent reported smoking cigarettes since delivery. CONCLUSIONS: This study indicates that alcohol and drug use are common among this sample of postpartum teenage mothers and that depression, stress, high support need, and peer group drug use are associated factors. Although this study cannot determine whether depression and stress precede or result from use of substances, attention to these factors appears warranted in the care of adolescent mothers.

Adolescent↗
PubMed1995

Postpartum reproductive management of dairy cows in a large Florida dairy herd.

Dairy cows (n = 199) were assigned randomly at Day 14 post partum to a control group or a programmed reproductive treatment group (PRT). Cows in the PRT group received 8 ug of GnRH on Days 14 and 50 post partum and 25 mg of PGF2alpha injected on Days 21, 34 and 57 post partum. Cows in the PRT group had a greater frequency of progesterone (P4) concentrations > 1 ng/ml (50% vs 30%; P < 0.01). Frequency of cows having P4 > 1 ng/ml at both Days 21 and 34 post partum was greater in the PRT group than in the control group (39% vs 20%; P < 0.01). Accumulation of days with a palpable cystic ovary was lower in the PRT than the control group (11.4% vs 6.5%; P < 0.05). The frequency of anestrous cows through Day 57 post partum was not different between the 2 groups. Cows that were anestrous had a lower body condition score throughout the postpartum period than the cyclic cows (2.7 vs <3.0; P < 0.01). Conception rate to first service, conception rate to all services, services per conception and days open were not different between the groups. Intensity of estrus detection was low for the study based on a low estrus detection rate (42%) and a low palpation pregnancy rate index (below 68%) throughout the study period. Accuracy of estrus detection was low based on the distribution of normal interestrus intervals for the study (19 to 23 d; 13.5%). It is concluded that programmed reproductive treatments during the postpartum period are functionally effective relative to altered ovarian activity; however, potential advantages to such a system are not evident without good estrus detection practices in a large commercial herd.

Journal Article↗
PubMed2003

Effects on breastfeeding of changes in maternity length-of-stay policy in a large health maintenance organization.

OBJECTIVE: The purpose of this study was to evaluate the effects on breastfeeding rates of a private-sector early discharge program and a subsequent government mandate guaranteeing 48 hours of hospital coverage. METHODS: Interrupted time-series analyses were conducted on retrospective data from the automated medical records of a large health maintenance organization in eastern Massachusetts. A population of 20 366 mother-infant pairs with normal vaginal deliveries between October 1990 and March 1998 was identified. This study period spanned the 2 interventions of interest: 1) the introduction of a new health maintenance organization protocol of 1 postpartum overnight hospitalization followed by a nurse home visit for normal vaginal deliveries, then 2) Massachusetts state minimum coverage legislation. Breastfeeding initiation and breastfeeding continuation among initiators (exclusive or with supplements) into the third month of life were determined through a text search of the first 90 days of infants' automated medical records. RESULTS: Both policies had dramatic impacts on length of stay (LOS); postpartum LOS <2 nights rose from 29% of pairs to 65% when the early discharge program was implemented, then fell to 15% after the state mandate. Breastfeeding initiation, however, rose gradually from 71% in the fourth quarter of 1990 to 82% in the first quarter of 1998, with no changes after the interventions. Continuation of breastfeeding among those who initiated remained constant at 73%. Younger maternal age, primiparity, low socioeconomic status, and nonwhite race all were found to be risk factors for lower rates of breastfeeding (either initiation or continuation), but there was no evidence of a decline in breastfeeding associated with shorter LOS among these vulnerable groups. CONCLUSIONS: Early postpartum discharge with outpatient breastfeeding support and a home visitor program has no adverse effects on initiation or continuation of breastfeeding.

Breast Feeding↗
PubMed1997

Effect of ruminant grade Menhaden fish meal on reproductive and productive performance of lactating dairy cows.

Menhaden fish meal, fed at 0.7 kg/d [2.7% of dietary dry matter (DM)], replaced blood meal and meat and bone meal (2.0% of dietary DM) in the diet fed at dairy A (n = 341) and replaced blood, meat and bone, and corn gluten meals (3.2% of dietary DM) in the diet fed at dairy B (n = 300). Cows consumed the experimental total mixed diets from approximately 24 to 109 d postpartum. Cows were synchronized for estrus using injections of GnRH agonist at 51 d postpartum. PGF2 alpha 7 d later, and artificial insemination at detected estrus. Resynchronization occurred using the same program if estrus was not detected. Diet failed to alter reproductive responses at synchronized artificial insemination. Pregnancy rate at 120 d postpartum was not altered by diet at dairy A (65.4% vs. 60.2%) but was improved by dietary fish meal at dairy B (31.9% vs. 41.3%; interaction of dairy and diet). The dynamics of corpus luteum regression were altered in cows fed fish meal at dairy B. Dietary fish meal did not influence milk production of cows at dairy A but increased production of milk (2.3 kg/d) and protein (0.1 kg/d) of second parity cows at dairy B. When dietary fish meal was fed to cows at dairy B, production of milk fat and 4% FCM was higher for cows in parity 5 or greater than that for cows in fourth parity.

Animal Feed↗
PubMed1998

Cost consequences of implementation of an early obstetrical discharge program in a military teaching hospital.

Objective: To evaluate the cost consequence of an early obstetrical discharge program in a military teaching hospital.Methods: The study involved a control group of routine obstetrical discharge patients with uncomplicated vaginal delivery from March to August 1994 and the study group of early obstetrical discharge (24-48 hours) patients with uncomplicated vaginal delivery from March to August 1996.Results: There were 1,042 total control patients with routine vaginal delivery from March to August 1994 totaling 2,668 hospital days with a mean number of hospital days of 2.56 per patient. The study group of early obstetrical discharge patients from March to August 1996 with uncomplicated vaginal delivery encompassed 1,050 patients with 1,965 days with mean hospital days of 1.87 per patient. The total cost of admissions (cost calculation of $1,221/hospital day) fell from $3,257,628 in the routine discharge group to $2,399,625 in the early discharge cohort showing a total cost savings of $858,003 over the 6-month study period. The average cost per admission fell from $3,126/day to $2,285/day without an increase in the postpartum pediatric or maternal adverse outcomes.Conclusion: An early obstetrical discharge program at a military teaching hospital showed significant cost savings without concomitant increase in pediatric or maternal adverse outcomes.

Journal Article↗
PubMed2002

Increasing awareness of danger signs in pregnancy through community- and clinic-based education in Guatemala.

OBJECTIVE: This study evaluates the effectiveness of a set of information, education, and communication (IEC) strategies designed to increase the awareness of danger signs in pregnancy, delivery, or the postpartum period among pregnant or recently pregnant women. METHODS: Three IEC programs were implemented in 4 regions of southwestern Guatemala between April 1997 and May 1998: (1) a clinic-based program involving the training of health providers in prenatal counseling and the provision of educational media to clients; (2) a community-based strategy consisting of radio messages regarding obstetric complications; and (3) educational sessions conducted through women's groups. Three surveys were conducted. In 1997, 637 pregnant women were interviewed at clinics where the interventions had been implemented. In 1998, 163 pregnant women using a subset of the same health clinics were interviewed. In 1999, a population-based survey of 638 pregnant and postpartum women was conducted. Using logistic regression, we model awareness of danger signs as a function of sociodemographic characteristics, prenatal care utilization, and IEC interventions. RESULTS: Among women using health clinics, the likelihood of having heard of danger signs nearly tripled between 1997 and 1998, when the clinic interventions were fully implemented. In 1999, those who had heard radio messages or participated in women's groups were, respectively, 3 times and 5 times more likely to have heard of danger signs in pregnancy. CONCLUSIONS: Safe motherhood programs can effectively increase knowledge of danger signs through clinic- and community-based educational strategies.

Adult↗
PubMedDate not supplied

Predicting length of stay of substance-using pregnant and postpartum women in day treatment.

Pregnant and postpartum substance-using women are a special population whose needs do not reflect those of the general substance-using communities. This study examined length of stay in a federally funded day treatment demonstration program in order to identify predictor variables that may help identify pregnant and postpartum substance-using women at high risk for dropping out of treatment. Variables from intake and exit questionnaires on a sample of 163 women were analyzed using multiple regression on both days in treatment and the logarithmic transformation of days in treatment. Few predictor variables were identified, although findings suggest that if a women is younger and self-referred, she may leave treatment sooner. As one of the first sets of published data on pregnant and postpartum women and retention in treatment, this study lays the groundwork for future research on the retention of pregnant and postpartum women in treatment, thereby facilitating the success of these women in overcoming their addiction.

Adult↗
PubMed1998

Volunteer peer counselors increase breastfeeding duration among rural low-income women.

BACKGROUND: The purpose of this demonstration project was to test the effectiveness of a volunteer peer counseling program for promoting breastfeeding in a community. METHODS: The two-year project was conducted in Iowa from September 1994 to September 1996. Both intervention and control groups were rural low-income pregnant and postpartum women who qualified for the Women, Infants and Children's (WIC) nutritional program. The intervention was initiated in two counties with 143 clients, of whom 72 completed the project. The control group was drawn from six counties that had received no significant breastfeeding promotion programs during the previous three years. The intervention was the assignment of trained volunteers with previous successful personal experience with breastfeeding as peer counselors to low-income pregnant women. Both before and after the baby was born, the volunteers taught a series of in-home, one-to-one lessons about healthy diet and breastfeeding, and maintained informal contact to answer questions or help with concerns. RESULTS: Women in the intervention group improved dietary intake when compared with the control group. Knowledge of breastfeeding and good nutrition improved slightly. Eighty-two percent of intervention compared with 31 percent of control group women initiated breastfeeding. Mean duration of breastfeeding for intervention and control group women was 5.7 and 2.5 weeks, respectively. At 4 weeks, 56 percent of intervention and 10 percent of control group women were still breastfeeding. CONCLUSION: A volunteer peer counseling program that provides low-income women with role models, accurate information, support, and encouragement can increase the duration of breastfeeding, and thus contribute to healthier infants.

Adult↗