Influences on breast-feeding by lower-income women: an incentive-based, partner-supported educational program.

OBJECTIVE

To determine the effects of a partner-supported, incentive-based educational program on rates and duration of breast-feeding among low-income women.

DESIGN

Women who expressed a willingness to participate in the breast-feeding educational program were randomly assigned to one of two groups: an intervention group and a control group who received usual breast-feeding education.

SETTING

Clinics of the Special Supplemental Food Program for Women, Infants, and Children in Flagstaff, Ariz.

SUBJECTS

Sixty-eight primiparous pregnant women with expected due dates between May 1992 and December 1992 were willing to participate in the study. Of these, 34 were randomly assigned to the intervention group and 34 to the control group. Approximately 81% of the women completed the study: 29 in the control group and 26 in the intervention group.

INTERVENTION

The intervention consisted of special incentives (prizes) for women and their partners to participate in a breast-feeding class for expectant couples and an educational series on childbirth. Women were also encouraged to use a breast-feeding support program in which peers serve as role models.

MAIN OUTCOME MEASURES

The primary outcome measure was infant feeding method. Data were collected from mothers in both groups at the time of discharge from the hospital and at 2 weeks, 6 weeks, and 3 months postpartum.

STATISTICAL ANALYSES PERFORMED

Binomial proportional analyses of the feeding data were performed.

RESULTS

Women in the intervention group reported a higher percentage of breast-feeding at all measurement times.

APPLICATIONS

These findings suggest that incentives, such as donated prizes, can be used to attract primiparous women from lower socioeconomic groups, along with their partners, to participate in educational interventions designed to promote breast-feeding. Participation by couples in breast-feeding promotion activities can dramatically increase the rate and duration of breast-feeding.