Srinivas Ganga L, Benson Mary, Worley Sarah, Schulte Elaine
Division of General Pediatrics, Medical University of South Carolina, Charleston, SC, USA
Columbia University Mailman School of Public Health, New York, NY, USA.
J Hum Lact. 2015 Feb;31(1):120-8. doi: 10.1177/0890334414548860. Epub 2014 Sep 5.
Whereas breastfeeding initiation rates have risen in all groups throughout the country, rates of breastfeeding duration have changed more slowly. Peer counseling has had some success in sustaining breastfeeding, but with intensive programs and variable effects.
We aimed to improve rates of any and exclusive breastfeeding at 1 and 6 months using a low-intensity peer counseling intervention beginning prenatally. We also planned to study the interaction of breastfeeding attitude and self-efficacy with the intervention.
One hundred twenty prenatal women underwent stratified randomization based on breastfeeding attitude, measured by the Iowa Infant Feeding Attitude Scale (IIFAS). The peer counselor contacted the intervention group by telephone or in clinic up to 4 months postdelivery. Study groups were compared on breastfeeding outcomes, adjusting for IIFAS strata, and on interactions with self-efficacy.
One hundred three women were followed to at least 1 month. Women with positive attitudes had significantly higher rates of initiation (93% vs 61%) and breastfeeding at 1 and 6 months (79% vs 25% and 12% vs 0%, respectively) than those with negative attitudes, regardless of intervention. After adjusting for self-efficacy, women who received peer counseling had significantly higher breastfeeding rates at 1 month (odds ratio = 3.2; 95% confidence interval, 1.02-9.8). The intervention group was marginally more likely to achieve their breastfeeding goal (43% vs 22%, P = .073).
Breastfeeding rates in all women improved during the study period. Breastfeeding attitude was more strongly associated with breastfeeding behavior than peer support. Peer counseling supported women with low self-efficacy and helped women achieve their breastfeeding goals.
尽管全国所有群体的母乳喂养启动率都有所上升，但母乳喂养持续率的变化较为缓慢。同伴咨询在维持母乳喂养方面取得了一些成效，但项目强度大且效果不一。
我们旨在通过从产前开始的低强度同伴咨询干预，提高产后1个月和6个月时的任何形式母乳喂养率及纯母乳喂养率。我们还计划研究母乳喂养态度和自我效能与该干预措施之间的相互作用。
120名孕妇根据爱荷华婴儿喂养态度量表（IIFAS）测量的母乳喂养态度进行分层随机分组。同伴咨询师在产后4个月内通过电话或门诊联系干预组。比较研究组的母乳喂养结果，并根据IIFAS分层进行调整，同时比较其与自我效能的相互作用。
103名女性至少随访至产后1个月。无论是否接受干预，态度积极的女性的母乳喂养启动率（93%对61%）以及产后1个月和6个月时的母乳喂养率（分别为79%对25%和12%对0%）均显著高于态度消极的女性。在对自我效能进行调整后，接受同伴咨询的女性产后1个月时的母乳喂养率显著更高（优势比 = 3.2；95%置信区间，1.02 - 9.8）。干预组实现母乳喂养目标的可能性略高（43%对22%，P = 0.073）。
在研究期间，所有女性的母乳喂养率均有所提高。母乳喂养态度比同伴支持与母乳喂养行为的关联更强。同伴咨询对自我效能较低的女性起到了支持作用，并帮助女性实现了母乳喂养目标。
