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Evaluation of the 'Best Start' Breast-feeding Education Program FREE

Brenda M. Hartley, MD; Mary E. O'Connor, MD, MPH
Arch Pediatr Adolesc Med. 1996;150(8):868-871. doi:10.1001/archpedi.1996.02170330094016.
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Objective:  To compare the frequency of breast-feeding before and after the "Best Start" breast-feeding educational program was implemented.

Design:  Preintervention-postintervention trial.

Setting:  A women's health center and children's hospital serving a low-income population.

Patients:  Ninety mother-infant pairs of whom the infants were born between January 2 and February 28, 1993, compared with 90 mother-infant pairs of whom the infants were born between January 2 and February 28, 1994.

Intervention:  Best Start, a breast-feeding education program, was presented to health professionals and clerical staff of the Women's Health Center. At the first prenatal visit, a woman is asked, "What do you know about breast-feeding?" instead of "Are you going to breast-feed or bottle-feed this baby?" The program elicits and acknowledges the mother's concerns and then educates her about the benefits of breast-feeding. This is repeated at each prenatal visit.

Outcome Measures:  Sociodemographic data and breast-feeding rates of preintervention groups were compared with those of postintervention groups. Both hospital and outpatient records were reviewed.

Results:  In 1993, 13 (15%) of 86 mothers breast-fed at hospital discharge compared with 25 (31%) of 81 in 1994 (P<.03). At the 2-week clinic visit, 11(13%) of 86 were still breast-feeding in 1993 compared with 17 (21%) of 81 in 1994 (P>.20). The impact on mothers aged 19 years or less was particularly marked, with a tripling of the breast-feeding rate at hospital discharge from 11% (2/18) in 1993 to 37% (10/27) in 1994.

Conclusion:  This simple, low-cost educational intervention with a change in the manner of presentation significantly improved the breast-feeding rates of this low-income population.Arch Pediatr Adolesc Med. 1996;150:868-871.

REFERENCES

Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LM.  Exclusive breastfeeding for at least 4 months protects against otitis media . Pediatrics 1993;;91:867-872.
Howie PW, Forsyth JS, Ogston SA, Clark A, du V Florey C.  Protective effect of breastfeeding against infection . BMJ . 1990;;300:11-16.
Merritt TG, Burr ML, Butland BK, et al.  Infant feeding and allergy: 12 month prospective study of 500 babies born into allergic families . Ann Allergy . 1988;; 61 ( (part 2) ):13-20.
Ryan AS, Rush D, Krieger FW, Lewandowski GE.  Recent declines in breast-feeding in the United States, 1984-1989 . Pediatrics . 1991;;88:719-727.
Jacobson SW, Jacobson JL, Frye KF.  Incidence and correlates of breast-feeding in socioeconomically disadvantaged women . Pediatrics . 1991;;88: 728-736.
Locklin MP, Naber SJ.  Does breastfeeding empower women? Insights from a select group of educated, low-income minority women . Birth . 1993;;20:30-35.
Kurinij N, Shiono PH, Rhoads GG.  Breastfeeding incidence and duration in black and white women . Pediatrics . 1998;;81:365-371.
Grossman LK, Larsen-Alexander JB, Fitzsimmons SM, Cordero L.  Breastfeeding among low-income, high-risk women . Clin Pediatr . 1988;;28:38-42.
Losch M, Dungy CI, Russell D, Dusdieker LB.  Impact of attitudes on maternal decisions regarding infant feeding . J Pediatr . 1995;;126:507-514.
Rassin DK, Richardson CJ, Baranowski T, et al.  Incidence of breastfeeding in a low socioeconomic group of mothers in the United States: ethnic patterns . Pediatrics . 1984;;73:132-137.
Bryant CA, Coreil J, D'Angelo SL, Bailey DFC, Lazarov M.  A strategy for promoting breastfeeding among economically disadvantaged women and adolescents . NAACOGs Clin Issues Perinatal Womens Health Nursing . 1992;;3:723-730.
Bryant C, Roy M. Best Start Training Program . Tampa, Fla: Best Start Inc; 1990;. Section C.

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References

Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LM.  Exclusive breastfeeding for at least 4 months protects against otitis media . Pediatrics 1993;;91:867-872.
Howie PW, Forsyth JS, Ogston SA, Clark A, du V Florey C.  Protective effect of breastfeeding against infection . BMJ . 1990;;300:11-16.
Merritt TG, Burr ML, Butland BK, et al.  Infant feeding and allergy: 12 month prospective study of 500 babies born into allergic families . Ann Allergy . 1988;; 61 ( (part 2) ):13-20.
Ryan AS, Rush D, Krieger FW, Lewandowski GE.  Recent declines in breast-feeding in the United States, 1984-1989 . Pediatrics . 1991;;88:719-727.
Jacobson SW, Jacobson JL, Frye KF.  Incidence and correlates of breast-feeding in socioeconomically disadvantaged women . Pediatrics . 1991;;88: 728-736.
Locklin MP, Naber SJ.  Does breastfeeding empower women? Insights from a select group of educated, low-income minority women . Birth . 1993;;20:30-35.
Kurinij N, Shiono PH, Rhoads GG.  Breastfeeding incidence and duration in black and white women . Pediatrics . 1998;;81:365-371.
Grossman LK, Larsen-Alexander JB, Fitzsimmons SM, Cordero L.  Breastfeeding among low-income, high-risk women . Clin Pediatr . 1988;;28:38-42.
Losch M, Dungy CI, Russell D, Dusdieker LB.  Impact of attitudes on maternal decisions regarding infant feeding . J Pediatr . 1995;;126:507-514.
Rassin DK, Richardson CJ, Baranowski T, et al.  Incidence of breastfeeding in a low socioeconomic group of mothers in the United States: ethnic patterns . Pediatrics . 1984;;73:132-137.
Bryant CA, Coreil J, D'Angelo SL, Bailey DFC, Lazarov M.  A strategy for promoting breastfeeding among economically disadvantaged women and adolescents . NAACOGs Clin Issues Perinatal Womens Health Nursing . 1992;;3:723-730.
Bryant C, Roy M. Best Start Training Program . Tampa, Fla: Best Start Inc; 1990;. Section C.

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