Skip to main content

Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse–Family Partnership


Background The Nurse–Family Partnership (NFP) is a home visiting program serving first-time, low-income mothers, with an area of focus on healthy early childhood development. Previous foundational trials of program effect on breastfeeding and immunizations have shown a mix of neutral and positive results. The present evaluation investigates these effects following program scale-up, using a large contemporary cohort of clients. Methods Nurse–Family Partnership client breastfeeding and immunization status were compared to National Survey of Children’s Health data and National Immunization Survey data, respectively. Sample differences in demographic covariates were adjusted using logistic regression. Results Nurse–Family Partnership clients were significantly more likely to have ever breastfed (adjusted prevalence ratio [aPR: 1.20 (1.17, 1.23)] and maintain breastfeeding at 6 [aPR: 1.17 (1.10, 1.24)] and 12 [aPR: 1.39 (1.25, 1.53)] months, but less likely to exclusively breastfeed at 6 months [aPR: 0.84 (0.70, 0.95)] NFP clients were significantly more likely to be up-to-date on immunizations at 6 [aPR: 1.23 (1.22, 1.25)], 18 [aPR: 1.33 (1.30,1.35)], and 24 [aPR: 1.15 (1.14, 1.16)] months of age than the reference cohort, with no significant difference at 12 months. Discussion Nurse–Family Partnership clients had more beneficial breastfeeding and immunization outcomes than children of mothers with demographically similar profiles. However, exclusive breastfeeding at 6 months lags behind the reference sample and represents a potential area for further improvement.

This is a preview of subscription content, access via your institution.


  • American Academy of Pediatrics. (2012). Policy statement—breastfeeding and the use of human milk. Pediatrics 129(3):e827–e841.

  • Atkinson, W. L., Pickering, L. K., Schwartz, B., Weniger, B. G., Iskander, J. K., Watson, J. C. (2002). General recommendations on immunization—recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicans (AAFP). MMWR 51(RR02), 1–36.

    PubMed  Google Scholar 

  • Child and Adolescent Health Measurement Initiative. DRC indicator data set 2011/2012. Enhanced data file. Data Resource Center for Child and Adolescent Health. Retrieved Feb 2, 2015 from

  • Kitzman, H. J., Olds, D. L., Henderson, C. R. Jr., Hanks, C., Cole, R., Tatelbaum, R., McConnochie, K. M., Sidora, K., Luckey, D. W., Shaver, D., Engelhardt, K., James, D., & Barnard, K. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries, and repeated childbearing: A randomized controlled trial. Journal of the American Medical Association, 278, 644–652.

    Article  CAS  PubMed  Google Scholar 

  • Miller, T. R. (2013). Nurse-Family Partnership home visitation: costs, outcomes, and return on investment. Calverton, MD: Pacific Institute for Research & Evaluation.

    Google Scholar 

  • Miller, T. R. (2015). Projected outcomes of Nurse-Family Partnership home visitation during 1996–2013, USA. Prevention Science, 16, 765–777.

    Article  PubMed  PubMed Central  Google Scholar 

  • National Center for Health Statistics. Vital statistics data available online—Birth data files. Last Edited Dec 30, 2014. Retrived on Feb 18, 2015 from

  • National Center for Health Statistics. National Immunization Survey—Datasets and related documentation for the National Immunization Survey, 2010 to Present. Last updated October 6, 2014. Retrived on Feb 20, 2015 from

  • O’Brien, R. A. (2005). Translating a research intervention into community practice: The Nurse-Family Partnership. The Journal of Primary Prevention, 26, 241–257.

    Article  PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R., Chamberlin, R., & Tatelbaum, R. (1986). Preventing child abuse and neglect: A randomized trial of nurse home visitation. Pediatrics, 78, 65–78.

    CAS  PubMed  Google Scholar 

  • Olds, D. L., Robinson, J., O’Brien, R., Luckey, D. W., Pettit, L. M., Henderson, C. R., Ng, R. N., Korfmacher, J., Hiatt, S., & Talmi, A. (2002). Home visiting by paraprofessionals and by nurses: A randomized, controlled trial. Pediatrics, 110, 486–496.

    Article  PubMed  Google Scholar 

  • United States Department of Health and Human Services, Centers for Disease Control and Prevention. (Personal communication on immunization standards) July 13, 2013.

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to William Thorland.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 37 KB)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Thorland, W., Currie, D., Wiegand, E.R. et al. Status of Breastfeeding and Child Immunization Outcomes in Clients of the Nurse–Family Partnership. Matern Child Health J 21, 439–445 (2017).

Download citation

  • Published:

  • Issue Date:

  • DOI:


  • Immunizations
  • Breastfeeding
  • Nurse–Family Partnership
  • Program evaluation