A Quasi-Experimental Evaluation of a Breastfeeding Support Program for Low Income Women in Michigan
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.
KeywordsBreastfeeding Breastfeeding support program Low income mothers Breastfeeding initiation Breastfeeding duration
- 1.US Department of Health and Human Services Office on Women’s Health. (2000). HHS blueprint for action on breastfeeding. Washington, DC: US Dept. of Health and Human Services.Google Scholar
- 5.World Health Organization Fifty-fifth World Health Assembly. (16 April, 2002). Infant and young child nutrition, a global strategy on infant and young child feeding. A55/15:5. Retrieved June 4, 2008, from http://www.who.int/gb/ebwha/pdf_files/WHA55/ea5515.pdf.
- 6.Centers for Disease Control and Prevention Breastfeeding Web site. Breastfeeding practices––results from the national immunization survey. Retrieved June 4, 2008 from http://www.cdc.gov/breastfeeding/data/NIS_data/2004/socio-demographic.htm.
- 7.Polhamus, B., Thompson, D., Dalenius, K., Borland, E., Smith, B., & Grummer-Strawn, L. (2006). Pediatric nutrition surveillance 2004 report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.Google Scholar
- 8.US Department of Health and Human Services. Healthy people 2010. Maternal, infant and child health. 16:19. Retrieved June 4, 2008, from http://www.healthypeople.gov/document/html/volume2/16mich.htm#_Toc494699668.
- 9.Guise, J. M., Palda, V., Westhoff, C., Chan, B. K. S., Helfand, M., & Lieu, T. A. (2003). The Effectiveness of Primary Care-Based Interventions to Promote Breastfeeding: Systematic evidence review and meta-analysis for the US preventive services task force. Annals of Family Medicine, 1, 70–78. doi:10.1370/afm.56.CrossRefPubMedGoogle Scholar
- 10.Protheroe, L., Dyson, L., Renfrew, M.J., Bull, J., & Mulvihill, C. (2008). The effectiveness of public health interventions to promote the initiation of breastfeeding. National Institute for Health and Clinical Excellence, Health Development Agency. 2003. Retrieved June 4, 2008, from http://www.nice.org.uk/nicemedia/documents/breastfeeding_evidencebriefing.pdf.
- 11.Renfrew, M. J., Spiby, H., D’Souza, L., Wallace, L. M., Dyson, L., & McCormick, F. (2007). Rethinking Research in Breastfeeding: A critique of the evidence base identified in a systematic review of interventions to promote and support breast-feeding. Public Health Nutrition, 10, 726–732. doi:10.1017/S1368980007387405.CrossRefPubMedGoogle Scholar
- 13.US Department of Agriculture, Food and Nutrition Service. (2008). WIC works resource system web page. Retrieved June 4, 2008, from http://www.nal.usda.gov/wicworks/Learning_Center/support_peer.html.
- 15.StataCorp. (2005). Stata statistical software: Release 9.0. College Station, TX: StataCorp.Google Scholar