Peer Counseling of Lactating Women in the Women, Infants and Children Supplemental Feeding (WIC) Program: A Cost-effective Analysis

Abstract

LEARNING OUTCOME: To evaluate the cost-effectivenss of using peer-counselors in the WIC Program to promote duration of exclusive breast-feeding.The PurPose of this study was to compare me duration and exclusivity breast-feeding and to evaluate the cost-effectiveness of using paid, peer-counselors to promote lactation in a WIC Program. Records were reviewed from women who participated in the peer counseling program (PC group, n=216). Data was collected regarding the mother's age and race, number of children, date of formula introduction, and breast-feeding duration. Data was also collected from 31 lactating women in the same WIC program who did not receive peer counseling (NC group) and from 115 women in another WIC program who did not offer peer counseling to any participants (control group). Characteristics of the women in these groups were similar: mean age 24 years, 50% African-American and 45% Caucasian. Mean number of contacts with the counselors was 4 during pregnancy and 7 during the postpartum period. Significantly more women in the PC group were still breast-feeding after eight weeks postpartum than the control group (51% vs. 14%, respectively, p<0.01). There was no significant difference in duration between the PC and NC groups. However, 64% of the PC groups continued to exclusively breast-feed whereas only 8% of the NC group were still exclusively breast-feeding after 8 weeks. This data was not available for the control group. An analysis was done to determine if the increased duration of exclusive breast-feeding by the PC groups was effective in reducing the cost of the food in the WIC Program. The monthly cost of a food package for lactating women was $33, compared to the combined cost of an infant and postpartum woman packages of $78. The monthly cost of peer counselors was $2,000 in this WIC program that served 633 lactating women/year. The projected monthly savings to the WIC program resulting from the use of peer counselors was $13,930 or $22/client.