Session: Got Milk? Lactation and Human Milk and Health Outcomes (Oral 17)

(OR17-01-21) Breastfeeding Peer Counseling Experiences Among Low-Income Women in the US: A Qualitative Evaluation

ON DEMAND

Presenting Author(s)

ER

Elizabeth C. Rhodes, PhD, MS

Postdoctoral Associate
Yale School of Public Health, Yale School of Medicine
New Haven, Connecticut, United States

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

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Co-Author(s)

MZ

Mahrukh Zahid, MPH

Yale School of Public Health
New Haven, Connecticut, United States

Disclosure: Disclosure information not submitted.
NA

Nafeesa Abuwala, MPH

Yale School of Public Health
New Haven, Connecticut, United States

Disclosure: Disclosure information not submitted.
GD

Grace Damio, MS, CD/N

Director of Research and Training
Hispanic Health Council
Hartford, Connecticut, United States

Disclosure: Disclosure information not submitted.
HL

Helen LaPlant, MS, IBCLC

Hispanic Health Council
Hartford, Connecticut, United States

Disclosure: Disclosure information not submitted.
WT

Walter Trymbulak, MD, PhD

Saint Francis Hospital and Medical Center
Hartford, Connecticut, United States

Disclosure: Disclosure information not submitted.
CC

Carrianne Crummett, MPH

Saint Francis Hospital and Medical Center
Hartford, Connecticut, United States

Disclosure: Disclosure information not submitted.
RS

Rebecca Surprenant, BA

Saint Francis Hospital and Medical Center
Hartford, Connecticut, United States

Disclosure: Disclosure information not submitted.
Rafael Pérez-Escamilla, BS, MS, PhD

Professor
Yale School of Public Health
New Haven, CT, Connecticut, United States

Disclosure: Disclosure information not submitted.

Objectives: Positive 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.

Methods: In-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.

Results: Peer 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.

Conclusions: Positive 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 Sources: NIH/NHLBI; CDC; W.K. Kellogg Foundation