Peer Counseling for Breastfeeding

(SMile Trial)

Recruiting at 1 trial location

Overseen By Jigna M Dharod, PhD

Age: 18+

Sex: Female

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

Trial Summary

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 data supports the effectiveness of the treatment Breastfeeding Peer Counseling Intervention?

Research shows that peer counseling programs are effective in increasing breastfeeding duration and rates, especially among low-income women. These programs have been successfully implemented in various settings, such as the WIC program, demonstrating their positive impact on breastfeeding practices. ^{1 2 3 4 5}

Is breastfeeding peer counseling safe for participants?

The research does not specifically mention any safety concerns related to breastfeeding peer counseling, suggesting it is generally considered safe for participants. ^{1 2 3 6 7}

How is the Breastfeeding Peer Counseling Intervention treatment different from other breastfeeding support treatments?

The Breastfeeding Peer Counseling Intervention is unique because it involves support from trained peers who have personal breastfeeding experience, offering tailored guidance and encouragement through methods like phone calls. This approach has been shown to effectively increase breastfeeding rates and duration, especially among low-income and minority women, by providing relatable and accessible support. ^{1 2 3 6 8}

What is the purpose of this trial?

The goal of this clinical trial is to learn how to improve exclusive breastfeeding rates in the Latine community. Breastfeeding initiation is high in this community, but many people ultimately do not breastfeed for as long as they would like to. The main questions it aims to answer are: Do Latine mothers benefit from peer counseling support from peer counselors who can speak Spanish and share their cultural background? Are mothers more likely to continue exclusive breastfeeding if additional funds are given so that the WIC exclusive breastfeeding package has the same cash value as the WIC formula feeding package? Researchers will compare participants in the intervention group (who receive peer counseling and additional funds) to a control group (who do not receive peer counseling or additional funds) to see if the intervention package improves breastfeeding rates. All participants (intervention and control) will complete weekly surveys about their feeding experiences ($8 per week). Members of the research team will also take infant weight/length measurements at home (twice during the first month and then at 2, 4, and 6 months). Participants will be recruited during pregnancy and the study will last for the first 6 months after their babies are born. Participants in the intervention condition will also be matched with Spanish-speaking Latine peer counselors who will visit mothers at home regularly (weekly at the beginning of the study, monthly at the end of the study) and receive $150 for every month they select the WIC exclusive breastfeeding package. Mothers can choose to receive an electric breast pump instead of one $150 payment.

Research Team

Jigna M Dharod, PhD

Principal Investigator

UNC Greensboro

Aunchalee E. L. Palmquist, PhD

Principal Investigator

Duke University

Jasmine M DeJesus, PhD

Principal Investigator

UNC Greensboro

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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

Participants in the intervention condition will be matched with Spanish-speaking Latine peer counselors who will visit mothers at home regularly (weekly at the beginning of the study, monthly at the end of the study) and receive $150 for every month they select the WIC exclusive breastfeeding package. Mothers can choose to receive an electric breast pump instead of one $150 payment.

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. But they will not be matched to a Spanish-speaking Latine peer counselors for regular home visits and will not receive $150 for selecting the WIC exclusive breastfeeding package.

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+

Findings from Research

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Prioritization of resources for participants in a peer counseling breastfeeding support program. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Evaluation of a peer counselling programme to sustain breastfeeding practice in Hong Kong. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Breastfeeding peer counseling: rationale for the National WIC Survey. [2017]

4. United States pubmed.ncbi.nlm.nih.gov

Reactions of Low-Income African American Women to Breastfeeding Peer Counselors. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

An evaluation of breastfeeding promotion through peer counseling in Mississippi WIC clinics. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Breastfeeding peer counseling: from efficacy through scale-up. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Telephone peer counseling of breastfeeding among WIC participants: a randomized controlled trial. [2021]

8. England pubmed.ncbi.nlm.nih.gov

"Real-world" effect of a peer counselor on breastfeeding outcomes in an urban prenatal clinic in the United States. [2021]