Breastfeeding MedicineVol. 17, No. 9 AbstractsFree AccessThe Academy of Breastfeeding Medicine27th Annual International MeetingBaltimore, MarylandSeptember 15–18, 2022Published Online:15 Sep 2022https://doi.org/10.1089/bfm.2022.29217.abstractsAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail 1. BABE: Breastfeeding and Antenatal Breastmilk Expression Randomized Control Trial.Merai Estafanous, Nicole Chong, Alexander Thomas, Gabrielle Cook, Elaine HartLoma Linda University School of MedicineCategory: ResearchBackground: The purpose of this randomized control trial was to improve the exclusive breastfeeding rate while hospitalized during the postpartum period, to improve the exclusive breastfeeding rate at 6 months, and to bolster mothers' self‐confidence in breastfeeding ability. Subjects were randomized to either initiate antenatal breast milk expression (ABE) at 37 weeks gestation combined with routine breastfeeding education, or routine education plus standard interventions. In the experimental group, the average amount of colostrum pumped was 52.3 mL (range 0.0 to 184.5mL); however, there were no statistically significant differences in exclusive breastfeeding between the experimental and control groups. The average amount of breastmilk produced antepartum was 54mL (median 6.8mL, range 0 ‐ 611mL). Subjects who produced more milk were more likely to exclusively breastfeed. There were no significant differences in safety outcomes between the ABE and control groups including gestational age at delivery, infant weight loss at discharge, 5 minute APGAR <6, or NICU admission rates. The ABE group had a significantly higher percentage of participants who presented in active labor and a significantly lower percentage of participants who had indicated Cesarean sections. The ABE group was also able to supplement with colostrum during the postpartum hospital admission at a significantly higher rate than the control group. This study did not identify a statistically significant increase in exclusive breastfeeding associated with ABE, however antepartum expression of breastmilk was shown to be safe and was associated with an increased likelihood of admission to Labor and Delivery for spontaneous labor.Results: 32% of women in the Antenatal Breast Expression (ABE) group used formula supplementation, compared to 41% of women in the control group (p = 0.2).Materials/Methods: The ABE group was instructed to pump 3x daily for 20 minutes starting at 37 weeks gestation. Breastfeeding at 6 months was examined in both groups.Conclusions: Although not statistically significant, the study found that ABE decreased formula supplementation in the hospital suggesting that it may be an effective measure to help patients meet their goals and CMQCC benchmarks for exclusive breastfeeding.2. The role of breastfeeding in racial and ethnic disparities in Sudden Unexpected Infant Death: A population‐based study of 13 million infants from the United States.Melissa Bartick1, Alexis Woods Barr2, Lori Feldman‐Winter3, Monica Guxens4, Henning Tiemeier51Mt Auburn Hospital Beth Israel Lahey Health2Carolina Global Breastfeeding Institute3Cooper Medical School of Rowan University4ISGlobal (Barcelona)5Harvard TH Chan School of Public HealthCategory: ResearchBackground: Sudden Unexpected Infant Death (SUID) disproportionately affects non‐Hispanic Black (NHB) and American Indian/Alaskan Native (AI/AN) infants, who have lower rates of breastfeeding than other groups. No existing literature investigates if breastfeeding explains disparities in SUID rates.Results: The overall SUID rate was 0.91/1,000 live births. NHB and AI/AN infants had the highest disparity in SUID relative to non‐Hispanic White (NHW) infants. Overall not‐breastfeeding was associated with SUID, adjusted Odds Ratio (aOR) 1.14 (95% Confidence Interval [CI]: 1.10, 1.19), the adjusted risk difference (AdjRD) was 0.12/1,000 live births. The aOR of not‐breastfeeding for SUID was 1.07 (95% CI: 1.00, 1.14) in NHB infants, and 1.29 (95% CI: 1.14, 1.46) in Hispanic infants. Breastfeeding minimally explained the higher SUID risk in NHB infants (2.3% mediated) and the lower SUID risk in Hispanic infants (2.1% mediated) relative to NHW infants. When adjusted for background risks, AI/AN mothers were more likely to initiate breastfeeding than similar NHW mothers, resulting in a negative mediation effect (‐0.9% mediated) relative to NHW infants. Asian mothers were less likely to initiate breastfeeding than similar NHW mothers.Materials/Methods: Using 13,077,880 live birth certificates and 11,942 linked SUID death certificates from 2015‐2018, we calculated odds ratios and adjusted risk differences of SUID by not‐breastfeeding across 5 racial/ethnic strata in the United States, adjusting for 12 covariates. We analyzed mediation by not‐breastfeeding in the race/ethnicity‐SUID association, adjusting for 12 covariates.Conclusions: Competing risks likely explain the lower aOR seen in NHB infants of not‐breastfeeding on SUID, suggesting that social/structural determinants must be addressed to reduce racial disparities in SUID. Reducing the rates of SUID of NHB and AI/AN infants will likely depend on confronting larger social and structural determinants of health through political solutions.3. Peer‐to‐Peer Milk Sharing Network among OBGYN Co‐workers in an Academic Institution.Abigail Liberty, Kimberley Bullard, Katherine AuOregon Health and Science UniversityCategory: ResearchBackground: Less than one third of physicians reach their personal breastfeeding goals and approximately one third are breastfeeding at 12 months. The World Health Organization recommends the use of human donor milk before the use of artificial supplementation to achieve optimal infant nutrition. The use of formal and informal milk sharing among physician parents has not been previously described.Results: Informal sharing occurred between 18 dyads which included 7 donors and 12 recipients over 7 years. Two individuals were both recipients and donors. Three recipients received milk from multiple donors. Two donors participated in both informal and formal milk donation. Milk sharing crossed traditional hierarchical boundaries with trainees sharing milk with supervisors and vice versa. Milk sharing was also noted between physician and nurse colleagues.Materials/Methods: A retrospective database of individuals known to have shared milk within a single OB/Gyn department was created. A network map described 7 years of sharing events. The network was plotted chronologically by the birthdate of the donor or recipient. Informal milk sharing outside of the department was excluded. Formal sharing through a HMBANA Milk Bank was included.Conclusions: This is the first ever milk sharing network analysis among physician co‐workers. This network highlights several key areas for future research including survey of recipient and donor experiences, the role of milk sharing in achieving personal breastfeeding goals, and the impact of personal experience with milk sharing on patient counseling.4. Passing on Protection: Frequency of Breastfeeding and Protection Against COVID‐19 in Young Children of Vaccinated Mothers.April CastilloStony Brook UniversityCategory: ResearchBackground: Many lactating parents extended breastfeeding relationships beyond initially planned during the COVID‐19 pandemic to provide children some immunity. It is unknown how much protection is conferred, and whether there is a dose‐response relationship or minimum threshold for protection. Booster recommendations raised further questions. This study aims to elucidate a minimum number of feeds necessary for observable passive immunity, and whether maternal boosters provide increased protection to breastfed children.Materials/Methods: This is a non‐blinded observational prospective cohort study of lactating physicians and their breastfed children assessing maternal COVID‐19 mRNA vaccination effects. One‐year outcome surveys were used for analysis including Chi square, Cochran‐Mantel‐Haenszel tests; logistic regression modeled factors affecting likelihood of COVID‐19 symptoms and diagnosis, estimating odds ratios controlling for high‐risk exposures. N = 534.Results: Weaning (<2 breastfeeds/day) is associated with increased risk of COVID diagnosis (AOR 2.190, 95%CI[1.049‐4.571], p = .033), while maternal booster is protective (AOR 0.334, 95%CI[0.169‐0.65], p = .002). Continued breastfeeding (≥2 times/ day) is associated with a decreased risk of needing medical attention if symptoms develop (AOR 0.348, 95%CI[0.174‐0.682], p = 0.001). Maternal booster decreased risk of developing symptoms (AOR 0.508, 95%CI[0.272‐0.951], p = 0.032) and needing medical attention (AOR 0.345, 95%CI[0.183‐0.649], p < 0.001).Conclusions: Both continued breastfeeding by mothers receiving mRNA COVID‐19 vaccines, and maternal booster dose, reduce children's risks of COVID‐19 diagnosis, symptoms, and needing medical attention compared to children weaned to <2 breastfeeds per day or whose mothers did not receive boosters, respectively. Lactating parents vaccinated against COVID‐19 may optimize children's protection by continuing breastfeeding relationships with minimum two feeds/day and getting the booster dose when recommended.5. History of Breastfeeding and Stroke Prevalence among Parous Females: Findings from the National Health and Nutrition Examination Survey (NHANES), 1999–2012.Gina Richardson1, Emily Mitchell2, Kalera Stratton3, Laura Kair4, Lynn Marshall51Oregon Health and Science University2Oregon Health and Science University3Oregon Health and Science University4University of California Davis5Oregon Health and Science UniversityCategory: ResearchBackground: Stroke is the third leading cause of death for women in the United States, resulting in twice as many deaths as breast cancer. There is a known relationship between hypertension and stroke, as well as breastfeeding a child and hypertension. However, there has been little research connecting these associations to evaluate whether breastfeeding a child may be associated with stroke risk later in life.Results: There is an inverse association between ever breastfeeding a child and prevalence of stroke that was significant in 20–64‐year‐olds (OR = 0.69, 95% CI: 0.47, 1.00).Materials/Methods: Multivariable logistic regression models were used to estimate crude and adjusted prevalence odds ratios for the association between breastfeeding and stroke.Conclusions: Ever breastfeeding a child was associated with lower prevalence of stroke in a nationally representative US sample of parous females 20 years and older. The inverse association was significant among those ages 20‐64 years but not among those 65 years and older.6. Racial Inequities in Breastfeeding Counseling among Pregnant People who use Cannabis.Laura Kair1, Adrienne Hoyt‐Austin2, Melissa Chen3, Brandie Bentley4, Karen Tabb5, Mishka Terplan6, Jennifer McAllister7, Scott Wexelblatt8, Aaron Murnan9, Chidiogo Anyigbo10, Christine Wilder11, Nichole Nidey121University of California Davis2UC Davis Health3UC Davis4University of Illinois at Urbana Champaign5University of Illinois at Urbana Champaign6Friends Research Institute7Cincinnati Children's Hospital8Cincinnati Children's Hospital9University of Cincinnati10Cincinnati Children's Hospital11University of Cincinnati12Cincinnati Children's HospitalCategory: ResearchBackground: Cannabis use has increased in the US among pregnant and postpartum people. Disparities in breastfeeding rates persist across racial/ethnic groups, with Black dyads experiencing the lowest initiation and continuation rates. The extent to which breastfeeding guidance given by healthcare providers to pregnant patients who use cannabis varies by maternal race/ethnicity is unknown.Results: 9.5% of respondents reported cannabis use during or 3 months prior to pregnancy. Of these respondents (weighted N = 51,793), 36.2% reported receiving advice from a provider prenatally not to breastfeed if using cannabis. This advice was associated with decreased odds of initiating breastfeeding (OR 0.6, 95%CI 0.3,0.99). Non‐Hispanic Black people were disproportionately advised not to breastfeed if using cannabis and had 4 times the odds of receiving this advice as non‐Hispanic white people (aOR 4.1, 95%CI 2.1,8.2).Materials/Methods: We analyzed data from the 2017‐18 CDC Pregnancy Risk Assessment Monitoring System survey from 9 states (AK, IL, ME, ND, NJ, NM, NY, PA, WV) with data on breastfeeding advice and cannabis use using weighted logistic regression models, unadjusted and adjusted for insurance, year, smoking, education, age, and state.Conclusions: In this study of birthing people who used cannabis prior to and/or during pregnancy, over one third of respondents reported advice to avoid breastfeeding if using cannabis. This advice was associated with lower odds of initiating breastfeeding, and non‐Hispanic Black birthing people were 4 times as likely as non‐Hispanic white people to be advised this. To achieve equitable maternal‐child health outcomes, interventions aimed at increasing breastfeeding initiation need to prioritize addressing structural and interpersonal racism in the context of maternal‐child healthcare.7. The Influence of Family Support on Exclusive Breastfeeding Practice of Mothers attending the National Hospital, Abuja, Nigeria.Opeyemi OshodiNational Hospital, Abuja, NigeriaCategory: ResearchBackground: Exclusive breastfeeding practice has remained suboptimal despite global efforts to promote it. Unfortunately, most breastfeeding interventions target mothers, with no corresponding understanding of the role of the family. A focus on family support is imperative, as evidence suggests that the family is probably more influential than health professionals in breastfeeding‐related matters.Results: High emotional support for exclusive breastfeeding from husbands (OR: 2.97; 95% CI: 1.28‐5.02) and high informational support for exclusive breastfeeding from husbands (OR: 3.72; CI: 1.91‐7.25) were significantly associated with the practice of exclusive breastfeeding among the mothers. Practical support from husbands as well as all dimensions of support from other family members were not associated with exclusive breastfeeding practice.Materials/Methods: A cross‐sectional study using a systematic sampling technique was conducted among 393 mothers of infants under six months in a tertiary Hospital in Abuja, Nigeria. Data for variables on exclusive breastfeeding practice and family support were collected using validated tools. Factors associated with exclusive breastfeeding practice were analysed using logistic regression. A p‐value of 0.05 was considered as statistically significant.Conclusions: Emotional and informational support specific for exclusive breastfeeding from husbands, is crucial in enabling mothers practice exclusive breastfeeding. As such, breastfeeding interventions should also be targeted towards these family members for maximum effectiveness.8. The Effects of Oral Feeding on the Preterm Infants' Microbiome and Metabolome.Keriann Schulkers Escalante1, Shiyu Bai‐Tong2, Megan Thoemmes3, Kelly Weldon4, Diba Mortazavi5, Jack Gilbert6, Sandra Leibel71University of California San Diego2University of Southern California3University of California San Diego4University of California San Diego5University of California San Diego6University of California San Diego7University of California San DiegoCategory: ResearchBackground: Breast milk is beneficial for preterm infants. Direct breastfeeding is ideal but preterm infants initially receive breast milk through an orogastric/nasogastric tube. The effects of tube feeds on the preterm infants' oral and gut microbiome and the breast milk microbiome and human milk oligosaccharide (HMO) diversity is unknown. We hypothesize that the diversity of the breast milk microbiome and HMOs change upon oral feeding, which alter the infant's microbiome and metabolome. We aim to elucidate this by analyzing stool, saliva and milk samples collected from a cohort of infants from the study: “The Association Between Milk Feedings, the Microbiome and Risk of Atopic Disease in the Preterm Population (MAP) Study”.Results: Previous analysis of a cohort of 54 infant stool samples showed a significant difference in bacterial community composition after the initiation of bottle (p = 0.014) and breastfeeding (p = 0.014), indicating changes to the stool microbiome at the onset of oral feeding. Further analysis of infant stool, saliva and maternal milk is ongoing.Materials/Methods: Samples were obtained before and after initiation of oral feeds. 39 infant stool and 44 infant saliva samples will undergo metabolomic and microbiome analysis using untargeted gas chromatography‐mass spectrometry and shotgun metogenomics. HMO analysis of 43 maternal milk samples will be performed by high performance liquid chromatography.Conclusions: Stool analysis revealed changes in the bacterial community composition after the initiation of oral feeds. Further analysis of saliva and maternal milk samples will determine any further variations in the microbial, metabolic and HMO signatures.9. Validating a questionnaire regarding Knowledge, attitude and practice (KAP) of Lactation consultants regards breastfeeding mothers with COVID.Shereen Abd Elghani SolimanPediatric & Neonatology ConsultantCategory: ResearchBackground: Breastmilk is the best source of nutrition for babies and protects them against illness. Disruption of breastfeeding can lead to a drop in milk supply, refusal by the infant to take the breast, and a decrease in protective immune factors contained in breastmilk. But mothers will be understandably worried and asking themselves whether coronavirus can be passed on through breastmilk and what they can do to protect themselves and their babies. During the coronavirus disease 2019 (COVID‐19) pandemic, mothers who were exposed or infected, along with their family and health care professionals, were unsure about breastfeeding their infant or even feeding their breast milk to their babies and whether and how to start or continue breastfeeding. We as IBCLCs, LC or healthcare workers didn't know if mothers with COVID‐19 can spread the virus to infants through breast milk, but it is unlikely based on what we do know.Women who have had COVID‐19 have high amounts of antibodies to the virus in their breast milk, which coat the inside of infants' noses and mouths, helping to block infection. Fresh (not frozen) milk is ideal because it has live infection‐fighting cells and offers the most protection.Results: Based on our results, we validated a questionnaire regarding Knowledge, attitude and practice (KAP) of Lactation consultants regards breastfeeding mothers with COVID.Materials/Methods: A questionnaire was developed following a standardized protocol that consisted of literature review, focused group discussions, and expert opinionConclusions: To the best of our knowledge, this is the first study that describes the development of a validated questionnaire with satisfactory content and reliability assessing the knowledge, attitude and practice of Lactation consultants regards breastfeeding mothers with COVID.10. Preterm babies and experience of their mothers in breastfeeding.Shereen Abd Elghani SolimanPediatric & Neonatology ConsultantCategory: ResearchBackground: Breastfeeding support is important for breastfeeding mothers; however, it is clear how mothers of preterm infants (< 37 gestational weeks) experience barriers to succeed breastfeeding their preterm babies.Results: Breastfeeding support to mothers of preterm infants was highly variable, either constructive or destructive depending on who provided support.Materials/Methods: This is qualitative study used data from 150 Egyptian mothers from questionnaires with open‐ended questions from three different healthcare sectors divided into three groups.Conclusions: Mothers of preterm infants lack much the support to breastfeed their preterm babies. The instructions that they receive was mainly destructive in both the governmental, University or private health care settings.11. Knowledge, attitude, and practice regarding COVID‐19 among breastfeeding mothers.Shereen Abd Elghani SolimanPediatric & Neonatology ConsultantCategory: ResearchBackground: Global pandemic COVID‐19 cases are increasing day by day which has created threats among people of the world. Egypt is becoming more vulnerable to COVID‐19 cases. Although various strategies and measures are undertaken by the Government, but people's commitment towards the control measures is pivotal to control the transmission of COVID‐19, which is critically affected by knowledge attitude and practice of people.Results: We assessed breastfeeding knowledge, attitudes and practices of 100 Egyptian mothers in the same household and their association with sociodemographic characteristics.Materials/Methods: A pre‐designed validated questionnaire was distributed electronically to breastfeeding mothers and the results were statistically analysed.Conclusions: The majority of the respondents are lacking confidence regarding the mode of transmission of COVID‐19, and majority of them believed that COVID‐19 is transmitted through breastfeeding which is incorrect.12. The impact of training of the Primary Health Care Physicians (PHCP) and healthcare workers towards implementation of the breastfeeding hospital initiatives and how to help breastfeeding mothers.Shereen Abd Elghani SolimanPediatric & Neonatology ConsultantCategory: ResearchBackground: The absence of breastfeeding support policies at the hospitals, failure of any referral of mothers with breastfeeding problems or follow‐up following discharge. Besides, absence of trained healthcare professionals experienced in supporting breastfeeding mothers, with no breastfeeding support groups or lactation consultant/specialist nor breastfeeding support department in the hospital, leads to failure of breastfeeding practices among mothers [8].Health care professionals need a continued highly specialized lactation education that provides common messaging to avoid maleficence and malpractice.Results: Training of the PHCP will produce experienced professionals, capable of helping mothers breastfeed efficiently.Materials/Methods: The participant physicians from selected primary health care facilities took a questionnaire to explore their experiences in supporting breastfeeding after being trained.Conclusions: Training of the PHCP will produce a next generation of experienced professionals, capable of helping mothers breastfeed efficiently increasing the rates of exclusive breastfeeding among mothers and limit the faulty practices.13. The Use of Auricular Acupuncture in Promoting Breastmilk Production in Lactating Mothers of Infants in the Neonatal Intensive Care Unit.Rana Alissa1, Mary Lim2, Diane Hutsell31University of Florida Jacksonville2University of Florida Jacksonville3Baptist HealthCategory: ResearchBackground: It has been well established that human milk is the gold standard for infant nutrition. All mothers of infants in the Neonatal Intensive Care Unit (NICU) are strongly encouraged to provide their own milk for their infants. Although donor milk from human milk banks is available, research has determined that mothers' own milk is superior in providing immunological and nutritional benefits. However, due to a variety of factors and despite many interventions to help mothers establish an adequate milk supply, milk production remains minimal for some.Results: 29 mothers met the inclusion criteria for enrollment in the study. 7 mothers declined participation. 22 qualified mothers consented, enrolled in the study and received acupuncture intervention. Nine (41%) mothers' milk production remained the same and thirteen (59%) have shown an increase in their milk production for an average of 101.7 ml a day.Materials/Methods: This study was conducted at level VI NICU in a major children's hospital and it was approved by the IRB. Mothers of infants born <35 weeks gestational age and admitted to NICU, whose breast milk production was <500 ml were qualified for this study. Two sessions of auricular acupuncture were performed and daily milk production was recorded one week later.Conclusions: Acupuncture improved breast milk production in the majority of participant mothers.14. BreastFeed Iowa Black Immigrant (BIBI) Partnership: Developing a framework for Culturally Sensitive Breastfeeding Interventions in a Black Immigrant Community.Temitope Awelewa, Alexandra MurraUniversity of IowaCategory: Program Development and FinancingBackground: Breastfeeding (BF) initiation rates are high but retention rates remain a nationwide problem. About four out of five mothers start out BF; however, only half of these mothers are still BF at six months. The disparities in BF retention is widest among non‐Hispanic blacks (a group that includes African immigrants) as compared to majority white populations. There is paucity of data on the unique needs of each immigrant community. This project aims to improve breastfeeding retention rates among black immigrant mothers in Johnson County Iowa area by 1) exploring factors that influence BF duration and 2) developing a framework for culturally sensitive BF interventionsMaterials/methods: Focus group discussions were conducted among black immigrant women who ever breastfed with a child of 0‐2years in the community. 40 Participants were recruited from the community by three community advisory group members who also assisted with focus group translations. Sessions were audio recorded and transcribedResults: Many participants were unaware of BF benefits and the superiority of BF over formula feeding. Most women felt uncomfortable using a breast pump and many did not pump at work. Many did not feel comfortable feeding their babies breast milk left in the breast for long periods after work. Many women stopped BF after return to work.Conclusions: Five themes emerged for developing a framework for interventions: knowledge gap of BF benefits, safety of expressed breastmilk, effect of acculturation on choice of formula feeding, influence of community leaders/peers on BF attitudes and using videos on social media for disseminating BF education.15. Association of Maternal and Umbilical Cord Blood High Sensitivity C‐reactive Protein Levels and Breastfeeding Duration, Fetal Development and Neonatal Health.Tamar Bakhtadze1, Ketvan Nemsadze2, Nino Kiknadze3, Vakhtang Beridze41Batumi M&C Hospital2Globalmed3Tbilisi State Medical University4Batumi M&C HospitalCategory: ResearchBackground: Previous studies have shown that elevated maternal CRP levels during pregnancy lead to fetal growth restriction, and are associated with endothelial, vascular dysfunction and suboptimal placental development.Results: CRP levels in maternal and umbilical cord blood was significantly associated with preterm births, SGA, referrals in NICU, inversely correlated with full‐term births and the duration of breastfeeding period. Hospitalization frequency was significantly correlated with: LBW <2500 g ‐ p < 0.001; the duration of breastfeeding period ‐ p < 0.001. The frequency of referrals in outpatient care units was significantly correlated with: LBW r = 0.499, p = 0.004; the duration of breastfeeding period ‐ p < 0.001. The duration of breastfeeding period was significantly correlated with: birth weight 3500‐4999 g ‐ p = 0.019; LBW, p < 0.001.Materials/Methods: Cohort Prospective Study, 32 women‐13‐17 week of pregnancy, Umbilical cord blood obtained during delivery Inclusion criteria: 13‐17 week of pregnancy; the informed consent of pregnants. − Exclusion criteria: extragenital diseases. The serum preparation was performed and stored from maternal blood specimens under lab‐specific conditions. CRP was determined by turbidimetry method.Conclusions: Thus, the statistical distribution of frequencies in the groups divided by the CRP levels in umbilical cord blood is well shown that the group of patients with elevated CRP levels in umbilical cord blood showed significantly lower mean value of the duration of breastfeeding period, frequencies of full‐term newborns and significantly higher frequencies of SGA, RDS, LBW, referrals.16. Breastfeeding peer support in the Baby Friendly Community in Italy: profile of the trained mothers and key education activities from mother to mother.Maria Enrica Bettinelli, Jessica Pecora, Marta GuerriniUniversity of MilanCategory: ResearchBackground: The support of breastfeeding mothers at the community level is multifaceted, surely fundamental is that given by the peer counsellor mothers. In Italy, there is no well‐defined and structured training for the breastfeeding peer mothers. Milan was the first Baby Friendly Community in Italy and since 2014, it has trained peer mothers to provide breastfeeding and parenting support to mothers at the community level. These trained mothers work together with health professionals, particularly those of the Family Health Centers.Results: 84 PCManswered. 94% are Italian, higher education, married or cohabit, mostly employed, prolonged breastfeeding. She received support in FHC for and want to help her peers.Materials/Methods: This is a descriptive study using online questionnaire of 48 questions sent to 119 peer counsellor mothers (PCM) trained in 2014‐ 2021 in the BFCI of Milan.Conclusions: The PCM is an Italian woman with higher education, emotional and economic stability. They contacted mothers on social media and phone calls. Knowledge of PCM by HP could strengthen the community breastfeeding support network.17.Withdrawn18. Racial and Ethnic Disparities in Care among Breastfeeding Infants with Ankyloglossia.Michele