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This cross-sectional study examines Maryland's women, infants, and children (WIC) breastfeeding initiation rates by program participation. The authors report on data regarding demographic and health characteristics and infant feeding practices for infants (n = 18 789) newly WIC-certified from January 1, 2007 to June 30, 2007. The authors compared self-reported, breastfeeding initiation rates for 3 groups: peer counselor (PC-treatment group) and two comparison groups, lactation consultant (LC), and standard care group (SCG). Reported breastfeeding initiation at certification was 55.4%. Multiple logistic regression analysis, controlling for relevant maternal and infant characteristics, showed that the odds of breastfeeding initiation were significantly greater among PC-exposed infants (OR [95% CI] 1.27 [1.18, 1.37]) compared to the reference group of SCG infants, but not significantly different between LC infants (1.04 [0.96, 1.14]) and the SCG. LC and SCG infants had similar odds of breastfeeding initiation. In the Maryland WIC program, breastfeeding initiation rates were positively associated with peer counseling. [ABSTRACT FROM AUTHOR]

To examine how individuals within a woman's life influence her infant feeding intention, we interviewed 441 African-American women on the breastfeeding attitudes and experiences of their friends, relatives, mother, and the baby's father. Women were interviewed at entry into prenatal care at clinics associated with one of four Baltimore WIC clinics chosen for a breastfeeding promotion project. Qualitative data were also collected among 80 women. Friends and "other" relatives were not influential. Grandmothers' opinions and experiences were important, but their influence was reduced after considering the opinion of the baby's father. The opinion of the woman's doctor was an independent predictor of infant feeding intention. Breastfeeding promotion programs should recognize the separate influence of fathers, health providers, and grandmothers in women's infant feeding decisions. [ABSTRACT FROM PUBLISHER]

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum. [ABSTRACT FROM PUBLISHER]

The infant feeding preferences of significant others have been shown to influence a pregnant woman's breastfeeding decision. Many researchers and policy makers are calling for the inclusion of a woman's significant other in the counseling and education of pregnant women regarding breastfeeding. This study reports on the impact of the significant other's infant feeding preferences and beliefs on a woman's intention to breastfeed, her initiation and successful initiation (longer than seven days) of breastfeeding. "Significant other" was defined as the person whom the pregnant woman reported as the one whose opinion "mattered the most to her" regarding feeding her infant. A randomly selected sub-sample of 133 women and their significant others was chosen from a larger infant feeding study. This sub-sample was heterogeneous with respect to age, education, and marital status. The women were interviewed during their third trimester of pregnancy and again at 7-10 days postpartum. Their significant others (71 percent baby's father and 29 percent baby's maternal grandmother), were interviewed during the woman's third trimester of pregnancy. Results indicate that a woman's intention to breastfeed is strongly and positively affected by the significant other's infant feeding preferences, initiation of breastfeeding is mediated through intention to breastfeed, and successful initiation of breastfeeding is also mediated through intention and is uniquely dependent on the pregnant woman's self-efficacy. [ABSTRACT FROM PUBLISHER]

The purpose of the current research was to identify demographic and psychosocial factors important in the decision to breastfeed among a sample of WIC participants in a rural area. One hundred and ninety-eight women completed both a prenatal interview during their third trimester of pregnancy and a second interview within one to three weeks postpartum. Twenty-seven percent of these WIC participants initiated breastfeeding. Multiple logistic regression analysis revealed that prenatal behavioral beliefs about the consequences of breastfeeding and formula feeding were the strongest predictors of breastfeeding initiation. The results suggest that education to improve the current low rates of breastfeeding among WIC participants should emphasize that formula feeding is neither more convenient nor easier than breastfeeding, and that breastfeeding need not limit mothers in public or social settings. [ABSTRACT FROM PUBLISHER]