The Impact of a Prenatal Education Video on Rates of Breastfeeding Initiation and Exclusivity during the Newborn Hospital Stay in a Low-income Population

Background: Guidelines recommend prenatal education to improve breastfeeding rates; however, effective educational interventions targeted at low-income, minority populations are needed as they remain less likely to breastfeed. Objective: To determine whether a low-cost prenatal education video improves hospital rates of breastfeeding initiation and exclusivity in a low-income population. Methods: A total of 522 low-income women were randomized during a prenatal care visit occurring in the third trimester to view an educational video on either breastfeeding or prenatal nutrition and exercise. Using multivariable analyses, breastfeeding initiation rates and exclusivity during the hospital stay were compared. Results: Exposure to the intervention did not affect breastfeeding initiation rates or duration during the hospital stay. The lack of an effect on breastfeeding initiation persisted even after controlling for partner, parent, or other living at home and infant complications (adjusted odds ratio [OR] = 1.05, 95% CI, 0.70-1.56). In addition, breastfeeding exclusivity rates during the hospital stay did not differ between the groups ( P = .87). Conclusion: This study suggests that an educational breastfeeding video alone is ineffective in improving the hospital breastfeeding practices of low-income women. Increasing breastfeeding rates in this at-risk population likely requires a multipronged effort begun early in pregnancy or preconception.

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Impact of Prenatal Education on Breastfeeding Initiation Among Low-Income Women

American Journal of Health Promotion ◽

10.1177/0890117120925342 ◽

2020 ◽

Vol 34 (8) ◽

pp. 919-922

Author(s):

Carolyn R. Ahlers-Schmidt ◽

Hayrettin Okut ◽

Jolynn Dowling

Keyword(s):

Low Income ◽

Vital Statistics ◽

Categorical Variables ◽

Fisher Exact Test ◽

Breastfeeding Initiation ◽

Prenatal Education ◽

Singleton Pregnancy ◽

Baby Talk ◽

Low Income Women ◽

Hispanic White

Purpose: To determine whether participants in the Baby Talk prenatal education program were more likely to initiate breastfeeding than nonparticipants. Design: Retrospective cohort study comparing women with a singleton pregnancy who were enrolled in Baby Talk with matched controls based on zip code, maternal age, race, language spoken, and payer source. Setting: Urban Midwest county. Sample: Baby Talk participants enrolled between November 2015 and December 2016 (n = 299) and matched controls identified through vital statistics records who were not enrolled (n = 1190). Intervention: A 12-hour prenatal education curriculum with 2.5 hours of breastfeeding content. Measures: The primary outcome was breastfeeding at hospital discharge as reported in vital statistics. Analysis: Likelihood-ratio χ2 and Fisher exact test were used to test the significant association between categorical variables. Results: Baby Talk participants were significantly more likely to initiate breastfeeding (93.65%) than matched nonparticipants (87.48%; P = .003). Non-Hispanic white and black Baby Talk participants were more likely to initiate breastfeeding than controls (96.15% vs 89.83%; 91.03% vs 77.02%, respectively; P < .05). Conclusions: Prenatal education has the potential to increase breastfeeding initiation among low-income women, especially non-Hispanic white and black. This study is limited as participants were from a single community, though Baby Talk was offered at 5 separate locations, and potentially from information bias as it was reliant on the accuracy of vital statistics data.

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The Impact of COVID-19 on Breastfeeding Rates in a Low-Income Population

Breastfeeding Medicine ◽

10.1089/bfm.2021.0238 ◽

2021 ◽

Author(s):

Maria Koleilat ◽

Shannon E. Whaley ◽

Cindy Clapp

Keyword(s):

Low Income ◽

Low Income Population ◽

Breastfeeding Rates ◽

The Impact

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Women's rural-urban migration in Lebanon

10.26756/th.2020.158 ◽

2019 ◽

Author(s):

◽

Sally N. Youssef

Keyword(s):

Internal Migration ◽

Low Income ◽

Lived Experiences ◽

Urban Migration ◽

Structural Factors ◽

Migrant Women ◽

Migration Studies ◽

Rural Urban Migration ◽

Low Income Women ◽

The Impact

Women’s sole internal migration has been mostly ignored in migration studies, and the concentration on migrant women has been almost exclusively on low-income women within the household framework. This study focuses on middleclass women’s contemporary rural-urban migration in Lebanon. It probes into the determinants and outcomes of women’s sole internal migration within the empowerment framework. The study delves into the interplay of the personal, social, and structural factors that determine the women’s rural-urban migration as well as its outcomes. It draws together the lived experiences of migrant women to explore the determinants of women’s internal migration as well as the impact of migration on their expanded empowerment.

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Doula Care Supports Near-Universal Breastfeeding Initiation among Diverse, Low-Income Women

Journal of Midwifery & Women s Health ◽

10.1111/jmwh.12065 ◽

2013 ◽

Vol 58 (4) ◽

pp. 378-382 ◽

Cited By ~ 22

Author(s):

Katy B. Kozhimannil ◽

Laura B. Attanasio ◽

Rachel R. Hardeman ◽

Michelle O'Brien

Keyword(s):

Low Income ◽

Breastfeeding Initiation ◽

Low Income Women

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Infant Feeding Practices and Perceived Optimal Breastfeeding Interventions among Low-Income Women Delivering at a Baby-Friendly Hospital

American Journal of Perinatology ◽

10.1055/s-0038-1676485 ◽

2018 ◽

Vol 36 (07) ◽

pp. 669-677 ◽

Cited By ~ 3

Author(s):

Adam K. Lewkowitz ◽

Nandini Raghuraman ◽

Julia D. López ◽

George A. Macones ◽

Alison G. Cahill

Keyword(s):

Infant Feeding ◽

Low Income ◽

Tertiary Care ◽

Feeding Practices ◽

Cross Sectional Study ◽

Perceived Usefulness ◽

Breastfeeding Initiation ◽

Infant Feeding Practices ◽

Cross Sectional ◽

Low Income Women

Objective To determine infant feeding practices of low-income women at a Baby-Friendly Hospital and to ascertain breastfeeding interventions they believe would increase exclusive breastfeeding. Study Design This cross-sectional study occurred at a tertiary care Baby-Friendly Hospital. Low-income women without breastfeeding contraindications were recruited at scheduled obstetrician/gynecologist appointments within 6 to 9 months of delivering a term, nonanomalous infant. Participants completed a survey. Outcomes included infant feeding patterns and perceived usefulness of proposed breastfeeding interventions. Results Of 149 participants, 129 (86.6%) initiated breastfeeding; by postpartum day 2 (PPD2), 47 (31.5%) exclusively breastfed, 51 (34.2%) breastfed with formula, and 51 (34.2%) exclusively formula fed. On a scale of 1 (“strongly agree”) to 5 (“strongly disagree”), women who supplemented with formula on PPD2 were significantly more likely than those who exclusively formula fed to agree education on neonatal behavior, 1 (interquartile range [IQR] 1, 2) versus 2 (IQR 1, 3); p = 0.026 and on-demand access to breastfeeding videos on latch or positioning, 1 (IQR 1, 2) versus 2 (IQR 1, 3), p = 0.043; 1 (IQR 1, 2) versus 2 (IQR 1, 3), p = 0.021, respectively, would have helped them exclusively breastfeed. Conclusion Though low-income women at a Baby-Friendly Hospital had high breastfeeding initiation rates, the majority used formula by PPD2. To increase breastfeeding rates among low-income women, future interventions should provide appropriate and effective breastfeeding interventions.

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Abstract 242: Evaluating the Impact and Barriers to a Collaborative Physician-pharmacist Care Model to Control Hypertension in a Low-income Population

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.242 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Kerrilynn C Hennessey ◽

Carolyn Hickman ◽

Brianne Krawczyk ◽

Michelle Opare ◽

Leslie Churchwell ◽

...

Keyword(s):

Blood Pressure ◽

Side Effects ◽

Blood Pressure Control ◽

Low Income ◽

Health Workers ◽

Pressure Control ◽

Low Income Population ◽

Early Results ◽

Patient Reported ◽

The Impact

Objectives: Physician-pharmacist collaborative practice models have emerged as an effective model for managing hypertension (HTN). We implemented this model in a low-income, hospital-based cardiology clinic and sought to identify programmatic features necessary to control HTN in this vulnerable population. Methods: Patients with persistently elevated blood pressure (>130/80) were referred by their primary cardiologist. Patients were excluded if they were pregnant, had acute kidney injury, or acute cardiovascular complaints including anginal chest pain, decompensated heart failure, or unstable arrhythmia. The initial pharmacist appointment occurred within 2 weeks of referral, with the goal of bi-weekly visits for 6 weeks or until blood pressure was controlled. Patients were prescribed home blood pressure cuffs and given specific instructions for home-based monitoring. Telehealth visits were made available to interested patients. During each encounter, pharmacists assessed response and side effects to medication, adherence, lifestyle behaviors, stressors, and social barriers to blood pressure control. Clinical management and barriers to HTN control were reviewed at standing weekly staff meetings that included cardiologists and pharmacists. Early results: Among 35 people referred, 22 patients attended at least one pharmacist visit. A total of 139 reminder or follow-up calls were made for these 22 patients. Among the first 35 referrals (mean age 58; 57% male; 65% African American or Latinx), 26% have documented substance use disorders, 34% have a mental health comorbidity, 20% were not taking their medications as prescribed on intake, and 17% had side effects from 2 or more prior antihypertensive medications. Medications adjustments were made in 21/43 patient visits (49% of visits). In 8/43 visits more than 1 medication change was made. The most common patient reported barriers to care include transportation (20%) and language barriers (11%). Discussion and Future Direction: Managing HTN in a low-income population requires attention to the social and contextual factors impacting blood pressure control. We plan to: 1) support the uptake of telehealth to address issues of transportation and access; 2) pilot blue-tooth connected blood pressure cuffs to facilitate home monitoring and management; and 3) partner with community health workers to assess best practices for capturing and addressing social determinants of health in the clinical setting.

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Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

BMC Public Health ◽

10.1186/s12889-020-09244-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Isabel Rodríguez-Gallego ◽

Fatima Leon-Larios ◽

Cecilia Ruiz-Ferrón ◽

Maria-de-las-Mercedes Lomas-Campos

Keyword(s):

Support Groups ◽

Exclusive Breastfeeding ◽

Intervention Group ◽

World Health ◽

Control Group ◽

Breastfeeding Initiation ◽

Primary Health ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

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Effectiveness of Workplace Lactation Interventions on Breastfeeding Outcomes in the United States: An Updated Systematic Review

Journal of Human Lactation ◽

10.1177/0890334418765464 ◽

2018 ◽

Vol 35 (1) ◽

pp. 100-113 ◽

Cited By ~ 12

Author(s):

Julia H. Kim ◽

Jong C. Shin ◽

Sharon M. Donovan

Keyword(s):

United States ◽

Low Income ◽

Exclusive Breastfeeding ◽

Maternity Leave ◽

The United States ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

White Ethnicity ◽

Observational Study Design ◽

The Impact

Background Returning to work is one of the main barriers to breastfeeding duration among working mothers in the United States. However, the impact of workplace lactation programs is unclear. Research Aim The aim of this study was to evaluate the effectiveness of workplace lactation programs in the United States on breastfeeding practices. Methods A systematic search was conducted of seven databases through September 2017. Articles ( N = 10) meeting the inclusion criteria of describing a workplace lactation intervention and evaluation in the United States and measuring initiation, exclusivity, or duration using an experimental or observational study design were critically evaluated. Two reviewers conducted quality assessments and reviewed the full-text articles during the analysis. Results Common services provided were breast pumps, social support, lactation rooms, and breastfeeding classes. Breastfeeding initiation was very high, ranging from 87% to 98%. Several factors were significantly associated with duration of exclusive breastfeeding: (a) receiving a breast pump for one year (8.3 versus 4.7 months), (b) return-to-work consultations (40% versus 17% at 6 months), and (c) telephone support (42% versus 15% at 6 months). Each additional service (except prenatal education) dose-dependently increased exclusively breastfeeding at 6 months. Sociodemographic information including older maternal age, working part-time, longer maternity leave, and white ethnicity were associated with longer breastfeeding duration. Conclusion Workplace lactation interventions increased breastfeeding initiation, duration, and exclusive breastfeeding, with greater changes observed with more available services. More evidence is needed on the impact of workplace support in low-income populations, and the cost-effectiveness of these programs in reducing health care costs.

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Home Visiting Effects on Breastfeeding and Bedsharing in a Low-Income Sample

Health Education & Behavior ◽

10.1177/1090198120964197 ◽

2020 ◽

pp. 109019812096419

Author(s):

Joshua P. Mersky ◽

Colleen E. Janczewski ◽

ChienTi Plummer Lee ◽

Ross M. Gilbert ◽

Cali McAtee ◽

...

Keyword(s):

Low Income ◽

Home Visiting ◽

Health Department ◽

The United States ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Public Health Department ◽

Safe Sleep ◽

Quasi Experimental ◽

The Impact

Background Research suggests that home visiting interventions can promote breastfeeding initiation, though their effects on breastfeeding continuation are unclear. No known studies have assessed the impact of home visiting on bedsharing. Aims To test the effects of home visiting on breastfeeding and bedsharing in a low-income, urban sample in the United States. Methods During a field trial conducted in Milwaukee, Wisconsin, from April 2014 to March 2017, referrals to a public health department were randomized to a Healthy Families America (HFA) program or a prenatal care and coordination (PNCC) program. Of the 204 women who accepted services, 139 consented to the study and were allocated to the two treatment groups, which were compared with each other and a third quasi-experimental group of 100 women who did not accept services. Data were collected at four time points up to 12 months postpartum. Results Breastfeeding initiation was higher among 72 HFA participants (88.4%; odds ratio [OR] = 2.7) and 67 PNCC participants (88.5%; OR = 2.2) than 100 comparison participants (76.5%). Similar results emerged for breastfeeding duration, though group differences were not statistically significant. Unexpectedly, bedsharing prevalence was higher among HFA participants (56.5%) than PNCC participants (31.1%; OR = 2.9) and comparison group participants (38.8%; OR = 2.0). Discussion Home visiting was linked to increased breastfeeding, while effects on bedsharing varied by program. Progress toward precision home visiting will be advanced by identifying program components that promote breastfeeding and safe sleep. Conclusion Further research is needed to examine whether home visiting reduces disparities in breastfeeding and safe sleep practices.

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