Clinically integrated breastfeeding peer counseling and breastfeeding outcomes.

Abstract

To evaluate whether clinically integrated breastfeeding peer counseling (ci-BPC) improved breastfeeding outcomes for a diverse cohort of Medicaid-enrolled patients. Medical records were reviewed for a random subset of patients delivering 2014-2015 (baseline, N = 147) and 2017-2019 (post-implementation, N = 281). Chi-squared and logistic regression evaluated differences in breastfeeding initiation, exclusivity, and duration, and results were stratified by race/ethnicity. Post-implementation, 90.4% of patients received ci-BPC. Compared to baseline, documented prenatal breastfeeding counseling increased from 5 to 84% (<0.001), and inpatient counseling increased from 12 to 55% (p < 0.001). Breastfeeding initiation was similar (86 to 89%, p = 0.28), while exclusivity increased from 21 to 31% (p = 0.03). Any breastfeeding ≥6 weeks increased from 29 to 65% (p < 0.001) and was most improved for Black (32 to 50%, p < 0.01) and Latinx patients (37 to 71%, p < 0.01). ci-BPC was associated with significant improvement in breastfeeding exclusivity and duration, and may address breastfeeding disparities.