Long Post
My name is Carolyn and I am a nursing student at the University of North Dakota. While doing research on breastfeeding, I started to wonder if starting a peer counseling program would help encourage women to initiate breastfeeding and continue breastfeeding for 6 months or more, which is ideal. I found that according to the American Academy of Pediatrics (1997) breastfeeding is recommended through the first year, stating exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for the first 6 mo. after birth and it is recommended that breastfeeding continue for at least 12 months.
We have been seeing an increase in women breastfeeding. Ryan, Wenjun & Acosta (2002) stated that the initiation of exclusive breastfeeding has increased from 43.5% in 1990 to 46.3% in 2001. The prevalence of breastfeeding at 6 months of age nearly doubled from 17.6% in 1990 to 32.5% in 2001. Another encouraging statistic is the largest increase in initiation of breastfeeding between 1996 to 2001 occurred among women who were black, younger than 20 years, no more than high school-educated, women who were not employed at the time they received the survey, and women which participated in the WIC program.
As I was reading about these statistical increases, I wondered if that percentage would continue to increase if women received support from a “non-health professional”, either being their partner or another individual. Giugliani, Caiaffa, Vogelhut, Witter, & Perman (1994) stated that fathers of breast-fed babies were proportionally more creative in giving suggestions on how fathers can support breast feeding mothers. That extra support would increase the likelihood of women breastfeeding. That would be an ideal situation if the woman’s partner was her primary support in the initiation and continuation of breastfeeding. However, it is becoming more common for single, young mother’s to have a child and not have a supportive partner for encouragement to continue breastfeeding. Another ideal situation would be for the nurse and physician to be a source of support for mothers 6 months to a year after the child’s birth, since they are the ones that women call with their ques
tions. However, with the nursing shortage that is not realistic. In contrast to that ideal situation, Dennis, Hodnett, Gallop & Chalmers (2002) stated that breast-feeding support programs by health care professionals did not substantially improve breast-feeding beyond 2 months post partum. They instead stated that significantly more mothers with a peer support volunteer continued to breastfeed at 3 months post-partum and did so exclusively. They also showed a positive result of breastfeeding peer support especially among socially disadvantaged women. Of the women evaluated with peer support, 85% said they would have a peer again, 65% felt their peer helped them reach their breastfeeding goals, 76% spoke with their peer when they experienced problems, 80% felt more confident after talking to their peer and 100% felt all new mothers should be offered a peer volunteer. The high satisfaction with and the acceptance of the peer support program indicate that the program, in c
onjunction with referrals to professional health services is effective (Dobson, et al, 2002).
Peer counselor volunteers could be trained by health care professionals to provide one-on-one support to a couple of mothers of their own culture. These volunteers could either go to the mother’s home once a week or call the mother and just be there for support, to answer their questions, and to just be a listening ear. Dobson & Murtaugh (2001) said volunteers could teach mothers how to identify signs of adequate infant intake and to encourage the women to seek professional assistance before routinely supplementing breastfeeding. Volunteers would continue to provide support for at least 6 months-1 year after the child’s birth, especially in the groups that have been historically less likely to initiate and continue breastfeeding. Do you think this type of program would ever work to increase the number of women breastfeeding especially beyond 6 months? Would it be beneficial to mothers? Would there be enough volunteers? Who would best be able to train volunteers? I am
interested to hear what you have to see in regards to this issue. Thank you.
Reference List
American Academy of Pediatrics (1997). Breastfeeding and the use of human milk. Pediatrics, 100,
1035-1039.
Dennis, C.L. (2002). Breastfeeding initiation and duration: A 1990-2000 literature review. Journal of
Obstetric, Gynecologic, & Neonatal Nursing, 31, 12-32.
Dennis, C.L., Hodnett, E., Gallop, R. & Chalmers, B. (2002). A randomized controlled trial evaluating the
effect of peer support on breastfeeding duration among primiparous women. Canadian Medical
Association Journal, 166(1), 21-28.
Dobson, B. & Martaugh, M.A. (2001). Position of the American Dietetic Association: breaking the
barriers to breastfeeding. Journal of the American Dietetic Association, 101, 1213-1220.
Giugliani, E., Bronner, Y., Caiaffa, W., Vogelhut, J., Witter, F., & Perman, J. (1994). Are fathers
prepared to encourage their partners to breast feed? A study about fathers’ knowledge of breast-
feeding. Acta Paediatrica, 83, 1127-1131.
Ryan, A.S., Wenjun, Z. & Acosta, A. (2002). Breastfeeding continues to increase into the new
millennium. Pediatrics, 110, 1103-1109.
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