Breastfeeding Peer Counselors Research Articles

Initial Feeding Method, WIC-Provided Lactation Support, and Breastfeeding Duration at an Urban Pediatric Primary Care Practice.

Breastfeeding (BF) is associated with improved maternal and infant health outcomes. However, underserved populations have limited access to lactation support. Our urban pediatric primary care practice partnered with WIC to integrate a BF peer counselor (BFPC) into newborn visits. To study the association of BF duration with (1) BFPC integration, (2) initial infant feeding methods (IFM). This is a retrospective cohort study of patients receiving BFPC support matched with those that did not based on race, ethnicity, and insurance. IFM were compared using chi-square. BF duration was compared using a t-test. These variables were compared across IFM using ANOVA. A cohort of 111 infant-mother dyads received BFPC support and 222 dyads did not (7/09/2019-4/25/2022). There was no significant difference in feeding methods between these groups. Compared to infants whose IFM was exclusive BF, fewer infants who initially used formula or both formula and breastmilk were exclusively BF at 2-month (55.8%, 8.2%, 10.9%), 4-month (54.8%, 6.3%, 14.5%), and 6-month visits (54.8%, 4.3%, 14.1%) (p < 0.001). There was a significant association between IFM and duration of any and exclusive BF (Formula only: 1week; BF and Formula: 3weeks; Exclusive BF: 14weeks; p < 0.001). A significant association was found between IFM and duration of BF. Early formula introduction was negatively associated with BF duration. The prenatal period may therefore be optimal for initiating BF support. Although there was no association between BFPC and BF duration, additional benefits of this intervention should be explored.

Implementation of a clinically integrated breastfeeding peer counselor program.

Reflecting disparities across the US, in 2015 publicly insured patients of the NorthShore Community Health Center (NSCHC) in Evanston, Illinois had lower breastfeeding rates than commercially insured patients. We used the Replicating Effective Programs framework to describe the design and implementation of a clinically-integrated breastfeeding peer counseling (ci-BPC) program to address these disparities. Patient focus groups and surveys informed program design, and a multidisciplinary clinical support team developed workflows that integrated the breastfeeding peer counselor (BPC) into the clinic and the postpartum unit. ci-BPC improved breastfeeding intensity and duration by providing every NSCHC patient with (1) prenatal lactation education; (2) hands on lactation care in the hospital; and (3) on-demand postpartum support. Total cost per patient was $297-386. The program was sustained after demonstrating potential cost-savings. An evidence-based, multidisciplinary collaboration resulted in a sustainable clinically integrated breastfeeding peer counseling program that improved breastfeeding outcomes.

The role of clinic-based breastfeeding peer counseling on breastfeeding rates among low-income patients

BackgroundDespite the benefits of breastfeeding (BF), rates remain lower than public health targets, particularly among low-income Black populations. Community-based breastfeeding peer counselor (BPC) programs have been shown to increase BF. We sought to examine whether implementation of a BPC program in an obstetric clinical setting serving low-income patients was associated with improved BF initiation and exclusivity.MethodsThis is a quasi-experimental time series study of pregnant and postpartum patients receiving care before and after implementation of a BPC program in a teaching hospital affiliated prenatal clinic. The role of the BPC staff included BF classes, prenatal counseling and postnatal support, including in-hospital assistance and phone triage after discharge. Records were reviewed at each of 3 time points: immediately before the hire of the BPC staff (2008), 1-year post-implementation (2009), and 5 years post-implementation (2014). The primary outcomes were rates of breastfeeding initiation and exclusivity prior to hospital discharge, secondary outcomes included whether infants received all or mostly breastmilk during inpatient admission and by 6 weeks post-delivery. Bivariable and multivariable analyses were utilized as appropriate.ResultsOf 302 patients included, 52.3% identified as non-Hispanic Black and 99% had Medicaid-funded prenatal care. While there was no improvement in rates of BF initiation, exclusive BF during the postpartum hospitalization improved during the 3 distinct time points examined, increasing from 13.7% in 2008 to 32% in 2014 (2009 aOR 2.48, 95%CI 1.13–5.43; 2014 aOR 1.82, 95%CI 1.24–2.65). This finding was driven by improved exclusive BF for patients who identified as Black (9.4% in 2008, 22.9% in 2009, and 37.9% in 2014, p = 0.01).ConclusionInpatient BF exclusivity significantly increased with the tenure of a BPC program in a low-income clinical setting. These findings demonstrate that a BPC program can be a particularly effective method to address BF disparities among low-income Black populations.

Effects of Breastfeeding Peer Counseling on County-Level Breastfeeding Rates Among WIC Participants in Greater Minnesota

ObjectiveU.S. breastfeeding outcomes consistently fall short of public health targets, with lower rates among rural and low-income people, as well as participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). The U.S. Department of Agriculture funded a subset of local WIC agencies in Minnesota to implement Breastfeeding Peer Counseling Programs (BFPCs) aimed at improving breastfeeding rates. We examined the impact of BFPCs on breastfeeding rates among WIC participants in Greater Minnesota (outside the Minneapolis–St. Paul metropolitan area). MethodsWe used data from the Minnesota WIC Information System for the years 2012 through 2019 to estimate the impact of peer counseling on breastfeeding duration using difference-in-differences models. Additionally, we examined results among rural counties and assessed the possibility of spillover effects by stratifying whether a county without BFPCs bordered one with BFPCs. ResultsAvailability of BFPCs resulted in a 3.1 to 3.4 percentage-point increase in breastfeeding rates at 3 months and a 3.2 to 3.7 percentage-point increase in breastfeeding rates at 6 months among WIC participants in Greater Minnesota. Among rural counties, results showed a statistically significant 4.1 to 5.2 percentage-point increase in breastfeeding duration rates. Both border and nonborder counties experienced positive impacts of BFPCs on breastfeeding rates, suggesting wide-ranging program spillover effects. ConclusionsBFPCs had a significant positive impact on breastfeeding duration. Findings indicate an opportunity for improving rural breastfeeding rates through increased funding for WIC BFPCs.

Training and Deployment of Pastors’ Wives as Peer Counselors for a Church-based Support Service to Improve Exclusive Breastfeeding Practice in Nigeria: A Descriptive Review of Feasibility and Effectiveness

Inadequate support services for common breastfeeding problems are major reasons why many nursing mothers quit exclusive breastfeeding practice in Nigeria. The recent exodus of doctors and other health-care workers has made the situation worse. Community-based interventions are urgently needed to avoid a relapse of the marginal increase of the exclusive breastfeeding rate in the country. Therefore, this study reviewed the feasibility and effectiveness of training and deploying pastors’ wives as breastfeeding peer counselors along with leaders of women’s Bible study classes as co-counselors in a church-based support service to boost exclusive breastfeeding practice in the country. Searches were conducted using appropriate keywords in journals and databases such as Google Scholar, Christian Journal of Global Health, and PubMed. Relevant papers were selected and read thoroughly. Ideas, phrases, and clauses that answered the research questions were synthesized into themes. Previous partnerships with the church to provide support for specific health problems such as HIV/AIDS had been fruitful. The adoption of the Community Infant and Young Child Feeding Counseling Package in small priority areas by the government and its development partners yielded positive results. However, partnerships are necessary to make the service available nationwide. The use of existing opportunities such as the network of pastors’ will be an economical and rational form of the volunteer community mobilizers. Community-based breastfeeding peer counseling has effectively increased the initiation and duration of exclusive breastfeeding and provided an opportunity to address other problems related to breastfeeding. However, the allocation of matching grants to local government areas will be necessary to increase nutrition interventions and to motivate peer counselors.

Breastfeeding Peer Counseling Experiences Among Low-Income Women in the US: A Qualitative Evaluation

ObjectivesPositive experiences with breastfeeding counseling is a key, but often overlooked aspect of high-quality, person-centered, and equitable breastfeeding services. We explored the experiences of women enrolled in the Breastfeeding Heritage and Pride program (BHP), an evidence-based breastfeeding peer counseling program serving predominately low-income minority women in Connecticut and Massachusetts throughout pregnancy and up to one year postpartum. MethodsIn-depth interviews were conducted with a purposive sample of 28 women receiving counseling from BHP peer counselors, community health workers who have successfully breastfed and completed specialized training on lactation management. Women were asked to describe their experiences with BHP and to share examples of when good quality counseling was and/or was not provided. Each interview was conducted in the woman’s preferred language (English or Spanish), audio-recorded, and transcribed verbatim. Data were analyzed using thematic analysis, and findings were organized according to the World Health Organization quality of care framework for maternal and newborn health, which describes three domains important for promoting positive experiences: effective communication; respect and dignity; and emotional support. ResultsPeer counselors were described as “friendly,” “warm,” and “genuine” in their interactions, which encouraged open communication. Peer counselors provided timely, credible breastfeeding information and used everyday words that facilitated understanding. Women appreciated that peer counselors respected their infant feeding decisions, including choices to supplement breast milk with infant formula or stop breastfeeding, and did not raise their voices, use rude language, or make judgmental comments that would constitute “mom shaming.” Women felt peer counselors gave them the “strength” to continue breastfeeding through consistent encouragement, especially when they lacked support from friends and family. ConclusionsPositive experiences with BHP were valued by women and empowered them to meet their breastfeeding goals, suggesting that efforts to expand access to high-quality breastfeeding peer counseling should measure and promote positive breastfeeding counseling experiences. Funding SourcesNIH/NHLBI; CDC; W.K. Kellogg Foundation.

Clinically integrated breastfeeding peer counseling and breastfeeding outcomes.

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.

Breastfeeding Peer Counselor Program in Malaysia: Impact on Breastfeeding Duration and Exclusivity

Background: The Malaysian Breastfeeding Peer Counselor Association (MBfPCA) is a pioneer non-governmental organization (NGO) of trained breastfeeding peer counselors in Malaysia. We explored the effect of peer counseling support on breastfeeding outcomes among postnatal mothers who delivered at a national tertiary teaching hospital and their satisfaction with the peer counseling services.Method: A total of 210 postpartum mothers were recruited in a single-blinded, randomized, controlled trial. Block randomization was used to allocate the participants into the intervention (I) group (n=105), who received telephone-based peer counseling support at 72 hours, 2 weeks, 1, 2, 4 and 6 months postpartum; and the control (C) group (n=105), who received routine breastfeeding advice. The infant feeding practices information was obtained at 2, 4 and 6 months postpartum from both groups. Data on maternal satisfaction with peer counseling services was acquired from the intervention group participants 6 months postpartum.Results: Ninety-four mothers were lost to follow up, leaving 116 (I=60, C=56) for analysis. The number of participants who practiced exclusive breastfeeding was higher in the intervention group at all intervals, with significant difference seen at 6 months postpartum (p = 0.035). Significant differences were also seen in the prevalence of breastfeeding between the groups at 4 and 6 months postpartum (p = 0.017 and p = 0.010). All participants who practiced exclusive breastfeeding found that peer counselors helped them reach their breastfeeding goals (p =0.001) and would recommend peer counseling services to others (p = 0.037).Conclusion: Peer counselor support in Malaysia increased the duration and exclusivity of breastfeeding and was well accepted among postnatal mothers.

P115 Breastfeeding Peer Counselors: Support Mothers Can Trust

<h3>Objective</h3> The Flint water crisis left many mothers of all income levels with limited trust in outside resources. With the support of the Greater Flint Community Foundation, a peer counselor was hired to support breastfeeding mothers. A peer counselor is a local mother representative of the community who has already developed trust within the community. This study looks at the effectiveness of community-funded breastfeeding peer counselors representative of their communities. <h3>Use of Theory or Research</h3> One of the most highly effective preventative measures a mother can take to protect the health of her infant is to breastfeed. In the US, 81% of babies initiate breastfeeding; 22% are exclusively breastfed 6 months later. According to the CDC, peer support programs are effective in increasing initiation, duration, and exclusivity of breastfeeding. Peer counseling is rooted in the theory of reasoned action which recognizes the influence of peers on individual behavior. Breastfeeding peer counselors help to normalize breastfeeding within their own community. <h3>Target Audience</h3> Pregnant and breastfeeding women who reside in Flint, Michigan. <h3>Program Description</h3> The peer counselor provided evidence-based education and support to increase initiation, duration, and exclusivity. The peer counselor educated, supported, and encouraged women to continue breastfeeding exclusively for 6 months and continue until at least 1 year of age. The peer counselor conducted home visits and was available during evenings and weekends. The number of visits varied depending on the needs of the mother. If possible, at least 1 visit was completed prenatally and minimally 1 visit within the first week after delivery. Additional contacts were provided through home visits, phone calls and FaceTime during the immediate postpartum period when one‐on‐one support for initiation of breastfeeding is critical. <h3>Evaluation Methods</h3> Women were recruited through referrals from a variety of community agencies that work with families in the city of Flint. Demographic (age, race, ethnicity, income), initiation, duration, and exclusivity information was collected from all participants who enrolled in program. <h3>Results</h3> Fifty presentations on benefits of breastfeeding reached 547 families between September 2018 – September 2019. Of the 103 mothers enrolled in the program, 98% initiated breastfeeding and 76% were still breastfeeding at 6 months. <h3>Conclusions</h3> Home visiting peer counselors were effective in promoting breastfeeding success in mothers in Flint. Many participants mentioned the importance of the peer counselor being a trusted mother representative of their community. This strategy should continue to be utilized and expanded to improve breastfeeding rates.

Breastfeeding peer counselling for mothers of preterm neonates: protocol of a stepped-wedge cluster randomised controlled trial

IntroductionAmong preterm infants, mother’s own milk feeding reduces neonatal morbidity and decreases the length of hospital stay. However, breastfeeding rates and duration are lower than among term infants. It is...

534: Reducing racial disparities in breastfeeding with the implementation of a breastfeeding peer counselor program

534: Reducing racial disparities in breastfeeding with the implementation of a breastfeeding peer counselor program

Effectiveness of Peer Counselor Support on Breastfeeding Outcomes in WIC-Enrolled Women

ObjectiveTo evaluate the effectiveness of different quantities and types of breastfeeding (BF) peer counselor (BFPC) support on BF outcomes in women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). DesignSecondary data analysis using BFPC data from an upstate New York county WIC (April 1, 2009 to March 30, 2011) merged with New York State Department of Health WIC surveillance data. ParticipantsA total of 2,149 WIC-enrolled mothers with live singleton births who accepted a BFPC referral and received different quantities and types of BFPC support (telephone, in person, and mailings). Main Outcome MeasuresSelf-reported BF initiation and duration at 30 days. AnalysisMultivariable logistic regression was used to estimate the odds of BF outcomes at 30 days associated with different levels of BFPC support. ResultsMothers who accepted BFPC referrals and had at least 1 phone conversation or in-person contact had a significant 35% to 164% increased odds of positive BF outcomes. Mailings did not significantly improve outcomes. Conclusions and ImplicationsThe Special Supplemental Nutrition Program for Women, Infants, and Children may need to identify barriers to BF duration and implement interventions in communities with low BF rates. Future studies may benefit from evaluating the impact of combined in-person support and phone contacts during the prenatal and postpartum periods on BF outcomes.

Impact of the Lactation Advice Through Texting Can Help (LATCH) Trial on Time to First Contact and Exclusive Breastfeeding among WIC Participants

ObjectiveDetermine the impact of a 2-way text messaging intervention on time to contact between participants and their breastfeeding peer counselors (BFPCs) and on exclusive breastfeeding (EBF) status at 2 weeks and 3 months postpartum. DesignMultisite, single-blind, randomized, controlled trial. SettingSpecial Supplemental Nutrition Program for Women, Infants, and Children (WIC) BFPC program. ParticipantsLow-income women (n = 174) participating in the WIC BFPC program. InterventionThe control group received the standard of care WIC Loving Support BFPC program. The intervention group received standard of care plus the text messaging intervention. Main Outcome MeasuresTime to contact with BFPC and EBF status. AnalysisThe 2-sample t test or χ2 test assessed whether an association existed between study variables and each outcome. Multivariable ordinal and binary logistic regression assessed the impact of the intervention on time to contact and EBF status. ResultsLactation Advice Through Texting Can Help had a significant impact on early contact between participants and BFPCs (odds ratio = 2.93; 95% confidence interval, 1.35–6.37) but did not have a significant impact on EBF (odds ratio = 1.26; 95% confidence interval, 0.54–2.66). Conclusions and ImplicationsLactation Advice Through Texting Can Help has the potential to facilitate the work of BFPCs by shortening the time-to-first-contact with clients after giving birth. Research is needed to identify the level of breastfeeding support staff coverage that WIC clinics must have to meet the demand for services created by Lactation Advice Through Texting Can Help.

Strengths and Challenges of the Alaska WIC Breastfeeding Peer Counselor Program: A Qualitative Study of Program Implementation

ObjectiveTo explore the implementation of a breastfeeding (BF) peer counselor (BFPC) program with Alaska Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). MethodsThe study used focus groups, surveys, and interviews, with transcripts analyzed in Atlas.ti and survey data summarized in Microsoft Excel. ResultsRespondents included 33 interviewed WIC staff and BFPCs, 25 clients in focus groups, and 129 surveyed clients. Common themes included BFPCs' innovative use of texting and online support groups assisting WIC clients' BF success. The BFPCs' knowledge, accessibility, and relatability were identified as positive program elements. Challenges included BFPCs' limited hours, funding, and in-person contact with clients, and confusion about the BFPCs' role. The BFPCs and staff also described unique documentation strategies, BF training, and perceived supports and barriers to WIC clients' BF. Conclusions and ImplicationsThe implementation of a BFPC program in Alaska WIC revealed novel documentation and outreach strategies, including texting and online support groups. Findings may be translatable to other peer counseling programs.

A Community Partnership to Support Breastfeeding Mothers of Late Preterm Infants

Mothers of late preterm infants need timely breastfeeding support after hospital discharge. Breastfeeding peer counselors with the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) can provide this support, but communication with hospitals is needed to facilitate early contact with women. We aimed to develop and implement a sustainable organizational process that would expedite support by providing WIC peer counselors access to mothers of late preterm infants before hospital discharge. Key strategies included creating a workable process; addressing barriers and stakeholder concerns; planning a pilot program to test the process; and inviting the WIC breastfeeding peer counselors to tour the hospital, meet nursing staff, and practice scripting their initial encounter with mothers. The organizational pathway currently is being implemented throughout the health system

Analisis Penerapan Breastfeeding Peer Counseling Pada Pasien Post Partum Fisiologis Dengan Masalah Keperawatan Menyusui Tidak Efektif Berdasarkan Teori Maternal Role Attainment-Becoming A Mother Ramona T. Mercer

The postpartum period is a critical time for the mother of one side is happy at the same times stressful to adapt after childbirth. Adaptation includes adjusting to build a positive interaction with the baby. One of the problems that occur in the postpartum period is the failure of mothers in exclusive breastfeeding. The low exclusive breastfeeding for mothers because they do not know the benefits of breastfeeding for children's health. Support from father also affect the success of exclusive breastfeeding for six months. Mother's decision to breastfeed affected family members information about the benefits of breastfeeding, as well as a lactation consultant. The purpose of this study is to analyze specific interventions , namely breastfeeding peer Counseling to improve exclusive breastfeeding in the postpartum period using theory of nursing, Maternal Role Attainment - Becoming a Mother developed by Ramona T. Mercer. The method used in this paper is a case report on the Physiological Postpartum Mothers treated in Kabupaten Kediri Hospital. On The assessment results according to the theory of Ramona T Mercer in the antisipatori data obtained on the condition of pregnancy that the mother does not experience problems, the ANC program appropriate with the schedule of health workers. In the Formal assessment of the phase Formal acceptance by the baby's mother obtained the difficulty breast-feeding mother to baby and family support is still lacking. In the Informal phase obtained for fear the baby's mother in the care especially during the current bathing and cord care. In the personal phase obtained mother feel mother’s role is very important in baby care. Breastfeeding Peer Counseling can be applied to postpartum mothers who experience difficulties with breastfeeding to their babies. The program is to motivate mothers to give babies the best nutrition to their infants through exclusive breastfeeding and provide psychological support to the mother to perform maintenance on the baby independently.

Breastfeeding Support: A Geographic Perspective on Access and Equity.

Clinical lactation professionals, breastfeeding peer counseling, and mother-to-mother support are important sources of information and guidance for helping mothers initiate and maintain breastfeeding in the early weeks, months, and years postpartum. However, there is limited information concerning the geographic barriers that mothers face when seeking this support. Research aim: This study aimed to identify the geographic barriers to breastfeeding support, delineate gaps in access, assess inequities in the distribution of local support, and highlight the underlying differences in access and equity for different demographic and socioeconomic groups. The locations of formal breastfeeding support resources were collected for the state of Ohio for 2016 and were combined with demographic and socioeconomic estimates and derived transportation catchment areas to conduct an analysis of spatial access and equity. Significant geographic gaps in formal breastfeeding support exist within the state of Ohio. Although urban areas benefit from a higher density of support options, including a wide variety of clinical experts and mother-to-mother support groups, inequities in exurban and rural areas were more strongly aligned with socioeconomic status than geography. In particular, the Special Supplemental Nutrition Program for Women, Infants, and Children offices in rural Ohio offer breastfeeding support to income-qualifying mothers but cannot address the needs of mothers who do not qualify. Spatial analytical approaches facilitate a more nuanced view of access and equity to breastfeeding support options, helping to both decompose important structural differences in the state of Ohio and identify locations that could benefit from additional breastfeeding support resources.

Abstract C50: Applying the Stages of Change Model to breastfeeding in African-American women: A qualitative study

Abstract Background: Breastfeeding is the optimal form of infant nutrition, and has numerous health benefits for both infant and mother. One such maternal health benefit is decreased likelihood of breast cancer. Breastfeeding trends in the United States have improved in the past decade. However, racial disparities remain, with African-American women having the lowest breastfeeding rates among all racial/ethnic groups. Although breastfeeding trends in African-American women have also improved greatly, current rates do not meet Healthy People 2020 objectives. According to the CDC, African-American women are more likely to develop an aggressive form of breast cancer (triple negative) and also have a higher mortality rate from breast cancer. In addition, breast cancer has a tendency to onset at younger ages in African-American women. Thus, efforts to improve breastfeeding initiation and duration rates in this population can help alleviate breast cancer disparities. The Stages of Change model is one behavioral health theory useful in gauging readiness to adopt a preventive health behavior. There is a gap in the breastfeeding literature regarding the usefulness of this theory for breastfeeding in African-American women. The current research described here helps to fill that gap. Study Question: How can the Stages of Change model be used to increase motivation and readiness to initiate and sustain breastfeeding in African-American women? Methods: A secondary data analysis was conducted of qualitative data from a dissertation exploring the long-term breastfeeding experiences of African-American women. In the first study, 3 focus group discussions were conducted with 23 WIC breastfeeding peer counselors (PCs) to better understand breastfeeding norms and behavior of the African-American women they serve. Focus groups were conducted at community health clinics and lasted approximately 90 minutes. In the second study, semi-structured individual interviews were conducted with 11 African-American mothers who were WIC participants (identified as positive deviants), who had breastfed one child for at least 6 months, and the breastfed child was younger than 2 years old. Interviews were conducted in participant homes or public settings (ie. library, café) and lasted approximately 60 minutes. Both focus groups and interviews were audio-recorded and conversations were transcribed. Data was coded by two researchers and analyzed using thematic analysis techniques. The Stages of Change model was used as a guide in the secondary data analysis. Results: WIC PC's and interview participants described historical and socio-cultural complexities influencing African-American women's breastfeeding behaviors. Four themes developed across both studies about African-American women's motivation and readiness to breastfeed using the Stages of Change model and strategies useful to encourage breastfeeding at each stage of behavioral change. 1) Pre-contemplation Stage: Increasing Breastfeeding Awareness (preconception and pregnancy); 2) Contemplation &amp; Preparation Stages: Breastfeeding Decision-Making (pregnancy and childbirth); 3) Action Stage: Initial Breastfeeding Triumphs and Trials (childbirth and early postpartum period); 4) Maintenance Stage: Committing to Long-term Breastfeeding (extended postpartum period). Conclusions: Findings indicate opportunities to enhance breastfeeding education and strengthen breastfeeding support for African-American women at each stage of behavioral change. Lessons learned can be used in designing culturally-tailored breastfeeding interventions for African-American women and also a survey tool to assess women's readiness to breastfeed. Healthcare providers and researchers should be aware of the unique historical and socio-cultural complexities influencing African-American women's breastfeeding behaviors when developing interventions. By improving breastfeeding in African-American women, aggressive breast cancer in may be prevented. Citation Format: Tyra Gross. Applying the Stages of Change Model to breastfeeding in African-American women: A qualitative study. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C50.

Long-Term Breastfeeding in African American Mothers.

According to the Centers for Disease Control and Prevention, 39.1% of African American infants are breastfed at 6 months. However, few studies have explored the breastfeeding experiences of African American women who successfully breastfeed to 6 months or longer durations. Research aim: The goal of this qualitative study was to explore the long-term breastfeeding experiences of low-income African American women using the positive deviance approach. African American women with breastfeeding experience were recruited through Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) breastfeeding peer counselors. Eligibility criteria included being age 18 or older, currently participating in WIC, and having breastfed one child for at least 6 months in the past 2 years. Semistructured, in-depth interviews were conducted with 11 participants. Interviews were audio-recorded and professionally transcribed. Transcripts were then analyzed for emerging themes using thematic analysis in NVivo software. Participants had on average three children each, with an average length of breastfeeding of 10.5 months per child. Four main themes developed: (a) deciding to breastfeed, (b) initiating breastfeeding, (c) breastfeeding long-term, and (d) expanding breastfeeding support. Participants offered culturally tailored suggestions to improve breastfeeding support for other African American women: prenatal discussions of breastfeeding with health care providers, African American lactation support personnel and breastfeeding support groups, and African American breastfeeding promotion in print and digital media. Women who participated in this study breastfed for longer durations than the national average for African Americans. Findings can inform practice and research efforts to improve breastfeeding rates in this population using lessons learned from successful women.

The Role of Early Maternal Support in Balancing Full-Time Work and Infant Exclusive Breastfeeding: A Qualitative Study.

Support of others is a key factor for mothers who choose to breastfeed their infants, including those who balance work outside the home and breastfeeding. However, little research has been done to understand how maternal support during the postpartum period impacts mothers' ability to later balance work and breastfeeding, in particular full-time work and exclusive breastfeeding. The results of this qualitative study indicate that the timing of support plays a key role in mothers' ability to successfully overcome barriers during the early postpartum period, thus building maternal self-efficacy in addressing problems encountered when they return to work. To understand the experience of low-income women who successfully balance full-time work and exclusive breastfeeding for the recommended 6 months, interviews were conducted with women who met study criteria for income level, work status, and exclusive breastfeeding. Breastfeeding peer counselors were also interviewed as key informants. Interviews were recorded, transcribed, and coded for themes. The results of both sets of interviews were triangulated with a focused literature review to assure the soundness of the qualitative analysis. Timing of support included acute support, such as help establishing a successful latch needed during the first 2 weeks after delivery, to deal with breastfeeding problems that mothers perceived as being mentally and emotionally overwhelming and longer-term support needed to overcome problems perceived as being less intense. The research invites further exploration into the relationship between breastfeeding support provided by mothers' support system, including healthcare professionals, during the postpartum period and rates of breastfeeding duration and exclusivity.