Evaluation of the Missouri WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) Breastfeeding Peer Counselling Programme

Objective: To evaluate the effectiveness of the peer counselling (PC) programme on breastfeeding initiation among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Missouri, and to identify factors that facilitate breastfeeding initiation.

Design: We used the data from the 2006 Missouri Pregnancy Nutrition Surveillance System, Missouri Live Birth Records and the Missouri WIC programme to compare breastfeeding initiation rates between PC and non-PC agencies. We used multilevel logistic regression, with individual participants being nested within agencies, to control for individual- and agency-level characteristics.

Results: The breastfeeding initiation rate in PC agencies was significantly higher than in non-PC agencies among prenatal participants, but the difference was not significant among postpartum participants. After controlling for maternal sociodemographic characteristics, compared with prenatal cases in non-PC agencies, prenatal cases in PC agencies were more likely to initiate breastfeeding (OR = 1.21; 95 % CI 1.03, 1.43), whereas postpartum cases were less likely to initiate breastfeeding. Among prenatal participants in PC agencies, longer duration of prenatal WIC enrolment was associated with a higher rate of breastfeeding initiation. After adjusting for maternal sociodemographic characteristics and other agency-level characteristics, participants of PC agencies with an international board-certified lactation consultant were more likely to initiate breastfeeding than participants of PC agencies without such a consultant (OR = 1.21; 95 % CI 1.01, 1.45).

Conclusions: Prenatal participation in the WIC breastfeeding PC programme (especially participation early during pregnancy) was associated with an increased rate of breastfeeding initiation in Missouri.