Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA.
Matern Child Health J. 2010 Jan;14(1):86-93. doi: 10.1007/s10995-008-0430-5. Epub 2008 Dec 11.
We examined the effectiveness of a peer counseling breastfeeding support program for low income women in Michigan who participate in WIC. Because there was more demand for services than could be met by the program, many women who requested services were not subsequently contacted by a peer counselor. We used a quasi-experimental methodology that utilized this excess demand for services to estimate the causal effect of the support program on several breastfeeding outcomes. We relied on data derived from administrative and survey-based sources. After providing affirmative evidence that our key assumption is consistent with the data, we estimated that the program caused the breastfeeding initiation to increase by about 27 percentage points and the mean duration of breastfeeding to increase by more than 3 weeks. The support program we evaluated was very effective at increasing breastfeeding among low income women who participate in WIC, a population that nationally breastfeeds at rates well below the national average and below what is recommended by public health professionals. Given the substantial evidence that breastfeeding is beneficial for both the child and mother, the peer counseling breastfeeding support program should be subjected to a cost/benefit analysis and evaluated at other locales.
我们考察了密歇根州参加 WIC 的低收入妇女同伴咨询母乳喂养支持计划的有效性。由于对服务的需求超过了该计划所能满足的程度，许多要求服务的妇女随后没有接到同伴顾问的联系。我们使用了一种准实验方法，利用这种对服务的过度需求来估计支持计划对几种母乳喂养结果的因果影响。我们依赖于从管理和基于调查的来源获得的数据。在提供了明确的证据表明我们的关键假设与数据一致后，我们估计该计划使母乳喂养的开始率增加了约 27 个百分点，并且母乳喂养的平均持续时间增加了 3 周以上。我们评估的支持计划在增加参加 WIC 的低收入妇女母乳喂养方面非常有效，而这一人群的母乳喂养率远低于全国平均水平，也低于公共卫生专业人员的建议。鉴于母乳喂养对儿童和母亲都有益的大量证据，同伴咨询母乳喂养支持计划应该进行成本效益分析，并在其他地方进行评估。
