Peer Counseling for Breastfeeding

(SMile Trial)

Recruiting at 1 trial location

Overseen By Jigna M Dharod, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of North Carolina, Greensboro

Disqualifiers: Under 18, High income, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

170 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if Hispanic mothers can increase their exclusive breastfeeding rates with the assistance of Spanish-speaking peer counselors and additional financial support. It will compare a group receiving the Breastfeeding Peer Counseling Intervention and extra funds to a group that does not. The goal is to discover if these interventions increase the likelihood of mothers continuing to breastfeed exclusively. Hispanic mothers who plan to breastfeed and qualify for WIC are ideal candidates for this trial. Participants will share their feeding experiences and have their baby's growth monitored over six months. As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance breastfeeding support for Hispanic mothers.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on breastfeeding support and does not mention medication restrictions.

What prior data suggests that this peer counseling intervention is safe for mothers and infants?

Research shows that breastfeeding peer counseling is safe and well-liked by mothers. Studies have found that mothers who join peer counseling sessions often experience more success with breastfeeding. For instance, one study discovered that mothers who worked with peer counselors were more likely to continue breastfeeding.

No reports indicate any harmful effects from peer counseling itself. Instead, it boosts mothers' confidence in breastfeeding. The counseling involves conversation and advice, so it doesn't carry the risks associated with medical treatments.

Overall, evidence suggests that this support can be a positive experience for mothers and their babies, with no significant risks reported in past studies. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Peer Counseling for Breastfeeding trial because it offers a unique, community-driven approach to support new mothers. Unlike standard care options, which often involve general counseling services, this intervention pairs mothers with Spanish-speaking peer counselors who provide personalized home visits. This method not only builds a supportive network but also offers financial incentives, like gift cards or breast pumps, and cash rewards for maintaining breastfeeding practices. The hope is that this tailored support and motivation can significantly improve breastfeeding rates and experiences for mothers.

What evidence suggests that the Breastfeeding Peer Counseling Intervention could improve exclusive breastfeeding rates?

Research has shown that breastfeeding peer counseling can greatly improve breastfeeding success. One study found that mothers who worked with peer counselors were 35% to 164% more likely to continue breastfeeding. Another study demonstrated that peer counseling increases the number of mothers who start and continue breastfeeding at 1 and 3 months after birth. Peer counseling has proven especially helpful for low-income communities and families of color. In this trial, participants in the intervention group will receive peer counseling, which could effectively encourage new mothers to breastfeed exclusively. ^{1 4 6 7 8}

Who Is on the Research Team?

Jasmine M DeJesus, PhD

Principal Investigator

UNC Greensboro

Jigna M Dharod, PhD

Principal Investigator

UNC Greensboro

Aunchalee E. L. Palmquist, PhD

Principal Investigator

Duke University

Are You a Good Fit for This Trial?

This trial is for Latine mothers who are at least 18 years old, have a single pregnancy with a baby born at full term (37 weeks or more) and of normal birth weight (>5 lbs 8 oz), intend to breastfeed, and have started breastfeeding without any congenital health issues in the infant. Participants must be eligible for WIC.

Inclusion Criteria

1. Confirmation of Latine origin

3. Breastfeeding has been initiated

2. Receives or eligible for WIC

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants in the intervention group receive peer counseling and additional funds to support exclusive breastfeeding

6 months

Weekly visits initially, then monthly visits

Control

Participants in the control group receive care-as-usual without additional peer counseling or funds

6 months

Follow-up

Participants are monitored for infant growth and breastfeeding outcomes

6 months

Home visits for infant measurements at 1, 2, 4, and 6 months

What Are the Treatments Tested in This Trial?

Interventions

• Breastfeeding Peer Counseling Intervention

Trial Overview The study tests if peer counseling support by Spanish-speaking Latine counselors and additional funds increase exclusive breastfeeding rates among Latine mothers. It compares an intervention group receiving these supports against a control group that does not, over the first six months postpartum.

How Is the Trial Designed?

Group I: Intervention group (peer counseling and funds) Experimental Treatment 2 Interventions

Participants in the intervention condition will be matched with Spanish-speaking peer counselors who will visit mothers at home regularly (weekly at the beginning of the study, monthly at the end of the study). In Month 1, mothers can choose to receive a $150 gift card or an electric breast pump. In Months 2-5, if infants are signed up for the WIC exclusive breastfeeding package, infants will receive $100 and mothers will receive $50. If infants are signed up for the WIC partial breastfeeding package, infants will receive $50 and mothers will receive $30.

Group II: Control group Active Control 1 Intervention

Participants in the control condition will receive care-as-usual. For example, they will have access to WIC services, which can include peer counseling.

Who Is Running the Clinical Trial?

University of North Carolina, Greensboro

Lead Sponsor

Trials

33

Recruited

16,700+

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator

Trials

2,513

Recruited

4,366,000+

Duke University

Collaborator

Trials

2,495

Recruited

5,912,000+

Published Research Related to This Trial

Peer counseling has been shown to be an effective intervention for promoting breastfeeding among low-income women, highlighting its potential in healthcare settings.

The paper also identifies barriers that limit the integration of peer counseling into medical settings, suggesting that addressing these challenges could enhance breastfeeding support programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breastfeeding peer counseling: rationale for the National WIC Survey. Bronner, Y., Barber, T., Miele, L.[2017]

A telephone peer counseling program for WIC participants significantly increased the duration of nonexclusive breastfeeding at 3 months postpartum, with an adjusted relative risk of 1.22, indicating a positive impact on breastfeeding support.

The program showed modest improvements in exclusive breastfeeding duration, particularly among Spanish-speaking clients, who had a lower likelihood of ceasing exclusive breastfeeding (adjusted odds ratio: 0.78).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telephone peer counseling of breastfeeding among WIC participants: a randomized controlled trial. Reeder, JA., Joyce, T., Sibley, K., et al.[2021]

Breastfeeding peer counseling (BPC) provided significant educational, emotional, and social support to African American mothers in WIC, positively influencing their breastfeeding experiences.

The study identified four key themes highlighting the benefits of BPCs, including increased confidence and support in countering negativity, but noted variability in the quality of contact between different WIC clinics, suggesting a need for standardized guidelines for BPC programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reactions of Low-Income African American Women to Breastfeeding Peer Counselors. Robinson, K., VandeVusse, L., Foster, J.[2022]

A systematic review of 26 studies found that breastfeeding peer counseling significantly improves rates of breastfeeding initiation, duration, and exclusivity, indicating its effectiveness as a supportive intervention.

Peer counseling not only enhances breastfeeding practices but also contributes to better health outcomes, such as reducing infant diarrhea and increasing the duration of lactational amenorrhea, making it a valuable component of maternal-child health programs globally.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breastfeeding peer counseling: from efficacy through scale-up. Chapman, DJ., Morel, K., Anderson, AK., et al.[2022]

Women who enrolled in the peer counseling breastfeeding support program after giving birth (postnatal) breastfed for significantly longer than those who enrolled before giving birth (prenatal), suggesting that postnatal support may be more effective.

Participants who exited the program while still breastfeeding had longer breastfeeding durations compared to those who discontinued altogether, indicating that targeted support for women at risk of stopping breastfeeding could enhance overall program effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prioritization of resources for participants in a peer counseling breastfeeding support program. Rozga, MR., Kerver, JM., Olson, BH.[2021]

The introduction of a peer counselor in a prenatal clinic did not significantly increase breastfeeding continuation at 6 weeks postpartum, with rates of 55.6% for those with a counselor compared to 49.1% without.

However, women who received support from a peer counselor reported higher satisfaction with breastfeeding training (98.2% vs. 83.6%) and were more likely to initiate breastfeeding (89.8% vs. 78.9%), suggesting that peer counseling can enhance the initial breastfeeding experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Real-world" effect of a peer counselor on breastfeeding outcomes in an urban prenatal clinic in the United States. Martinez, NG., Strohbach, A., Hu, F., et al.[2021]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3115698/

Breastfeeding Peer Counseling: From Efficacy through Scale-up We conclude that breastfeeding PC initiatives are effective and can be scaled up in both developed and developing countries.

2. jamanetwork.com jamanetwork.com/journals/jamapediatrics/fullarticle/485814

Effectiveness of Breastfeeding Peer Counseling in a Low ... Peer counselors can significantly improve breastfeeding initiation rates and have an impact on breastfeeding rates at 1 and 3 months post partum.

3. bmcpregnancychildbirth.biomedcentral.com bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06395-1

The role of clinic-based breastfeeding peer counseling on ... Breastfeeding Peer Counseling (BPC) has been found to improve breastfeeding outcomes for low-income communities and families of color. A ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1499404619301319

Effectiveness of Peer Counselor Support on Breastfeeding ... Mothers 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 ...

5. mdpi.com mdpi.com/2072-6643/16/7/988

Effectiveness of a Postpartum Breastfeeding Support ... In conclusion, the midwife-led group intervention supporting breastfeeding proved to be effective at maintaining exclusive breastfeeding at 6 months postpartum ...

6. bmcpregnancychildbirth.biomedcentral.com bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03360-6

“Real-world” effect of a peer counselor on breastfeeding ... Peer counselor exposure was not associated with the primary outcome of continued breastfeeding at 6 weeks (55.6% with peer counselor versus 49.1 ...

7. jamanetwork.com jamanetwork.com/journals/jama/fullarticle/2832389

Primary Care Behavioral Counseling Interventions to ... The USPSTF concludes with moderate certainty that primary care behavioral counseling interventions to support breastfeeding have a moderate net benefit.

8. publications.aap.org publications.aap.org/pediatrics/article/134/3/e700/74172/Telephone-Peer-Counseling-of-Breastfeeding-Among

Telephone Peer Counseling of Breastfeeding Among WIC ... Outcomes included breastfeeding initiation as well as dichotomous outcomes of partial or exclusive breastfeeding for at least 1, 3, or 6 months.