Let's Talk About Breastfeeding: The Importance of Delivering a Message in a Home Visiting Program.

PURPOSE To examine the potential impact of paraprofessional home visitors in promoting breastfeeding initiation and continuation among a high-risk population. DESIGN A secondary analysis of program data from a statewide home visitation program. SETTING Thirty-six Healthy Families New York sites across New York State. SUBJECTS A total of 3521 pregnant mothers at risk of poor child health and developmental outcomes. INTERVENTION Home visitors deliver a multifaceted intervention that includes educating high-risk mothers on benefits of breastfeeding, encouraging them to breastfeed and supporting their efforts during prenatal and postnatal periods. MEASURES Home visitor-reported content and frequency of home visits, participant-reported breastfeeding initiation and duration, and covariates (Kempe Family Stress Index, race and ethnicity, region, nativity, marital status, age, and education). ANALYSIS Logistic regression. RESULTS Breastfeeding initiation increased by 1.5% for each 1-point increase in the percentage of prenatal home visits that included breastfeeding discussions. Breastfeeding continuation during the first 6 months also increased with the percentage of earlier home visits that included breastfeeding discussions. Additionally, if a participant receives 1 more home visit during the third month, her likelihood of breastfeeding at 6 months increases by 11%. Effect sizes varied by months postpartum. CONCLUSIONS Delivering a breastfeeding message consistently during regular home visits is important for increasing breastfeeding rates. Given that home visiting programs target new mothers least likely to breastfeed, a more consistent focus on breastfeeding in this supportive context may reduce breastfeeding disparities.