Ray Maile C, Gullick Margaret M, McGinnis Sandra L, Kirkland Kristen A
Center for Human Services Research, College of Integrated Health Sciences, State University of New York, University at Albany, 135 Western Avenue, Richardson Hall 386, Albany, NY, 12222, USA.
Department of Health Policy, Management, and Behavior, College of Integrated Health Sciences, State University of New York, University at Albany, Albany, NY, USA.
Matern Child Health J. 2025 Sep 15. doi: 10.1007/s10995-025-04173-9.
Breastfeeding is associated with many health benefits for both mothers and children, yet U.S. breastfeeding rates are far below the Healthy People 2030 goals. Furthermore, disparities in breastfeeding rates exist, whereby some demographic groups have even lower rates. This study examines the association between dosage of breastfeeding conversations with a home visitor on breastfeeding continuation in participants who enrolled postnatally.
This cohort study examines the impact of breastfeeding conversations with a home visitor on breastfeeding continuation on 1,422 mother-child pairs enrolled postnatally in Healthy Families New York (HFNY), a family support home visiting program. Multivariable logistic regression models analyzed longitudinal data, adjusting for several known predictors of breastfeeding that could confound the association between breastfeeding conversations and breastfeeding continuation.
The analyses reveal a significant association between the rate of breastfeeding conversations during home visits in the preceding period and increased odds of breastfeeding continuation for 1-2 months (p = 0.013), 2-3 months (p < 0.001), 3-6 months (p < 0.001), and six months or greater (p = 0.001). The dose-response relationship and longitudinal nature of the data could suggest causality. Importantly, the impact of breastfeeding conversations is more pronounced among mothers born in the U.S., a group with known disparate breastfeeding outcomes. Further, this study finds that the number of home visits predicts breastfeeding continuation past six months (p < 0.001).
This study offers important insights into the role of a home visiting intervention to promote breastfeeding and reduce breastfeeding disparities without the excessive costs of an intervention designed solely for breastfeeding.
母乳喂养对母亲和孩子都有诸多健康益处，但美国的母乳喂养率远低于《健康人民2030》的目标。此外，母乳喂养率存在差异，一些人口群体的母乳喂养率甚至更低。本研究探讨了产后登记参与的参与者中，与家访人员进行母乳喂养相关对话的次数与母乳喂养持续情况之间的关联。
这项队列研究考察了与家访人员进行母乳喂养相关对话对1422对母婴母乳喂养持续情况的影响，这些母婴是产后登记参加纽约健康家庭（HFNY）这一家庭支持家访项目的。多变量逻辑回归模型分析了纵向数据，并对几个已知的母乳喂养预测因素进行了调整，这些因素可能会混淆母乳喂养相关对话与母乳喂养持续情况之间的关联。
分析显示，前一时期家访期间母乳喂养相关对话的频率与母乳喂养持续1 - 2个月（p = 0.013）、2 - 3个月（p < 0.001）、3 - 6个月（p < 0.001）以及六个月及以上（p = 0.001）的几率增加之间存在显著关联。数据的剂量反应关系和纵向性质可能表明存在因果关系。重要的是，母乳喂养相关对话的影响在美国出生的母亲中更为明显，这是一个已知母乳喂养结果存在差异的群体。此外，本研究发现家访次数可预测母乳喂养持续超过六个月（p < 0.001）。
本研究为家访干预在促进母乳喂养和减少母乳喂养差异方面的作用提供了重要见解，且无需专门为母乳喂养设计的干预措施所带来的高昂成本。
