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Table 7 Community level healthcare facility breastfeeding interventions among women of color in the U.S.: Post-partum

From: Impact of breastfeeding interventions among United States minority women on breastfeeding outcomes: a systematic review

Study/Setting

Study Design/ methods

Study Population

Exposure/Intervention

Outcomes Results

Grade

Pugh et al. [71]

Urban hospitals

Design: RCT

Data: baseline, 6, 12, 24 wks p.p. phone/home survey

n = 168 intervention n = 160 control

87% AA

Three 1-4th wks p.p. PC home visits; PC bi-weekly phone calls, nurse available 24/7 by pager first 24 wks p.p.

At 6 wks p.p., intervention mothers 1.71 times more likely to BF. No significant %BF differences at 12 and 24 wks p.p.

Low

Moon et al. [72]

Urban Hospital

Design: RCT

Data: surveys; 1–2 d p.p., 2 wks, 2–3 mo, 5–6 mo p.p.

n = 569 intervention

n = 625 control

100% AA

Information on AAP safe sleep practices to reduce SIDS risk

No impact on BF or EBF rates despite emphasis on not bedsharing.

Very Low

Hopkinson et al. [73]

Community clinic

Design: RCT

Data: Chart review, baseline survey, phone at 4 wks p.p.

n = 255 intervention

n = 267 control. 87.5% H

Moms mix feeding scheduled for a 3–7 p.p. visit to clinic; PC & IBCLC BF support;

Intervention increased EBF at 4 wks, mostly due to less water and herbal teas (vs. formula)

Moderate

Bunik et al. [74]

Community health center

Design: RCT

Data: Hospital, 1,3,6 mo p.p. phone survey

n = 161; 87% H

n = 180; 90% H

daily BF support phone calls; bilingual nurses; 1st 2 wks p.p.

No differences in any or predominantly BF at 1, 3, 6 mo p.p.

Very Low

Harris-Luna &

Badr [75]

Obstetric clinics

Design: Pragmatic RCT

Data: in-person baseline survey; 12 wks phone survey

n = 31 intervention

n = 30 control; 100% H; Southern CA

Promotoras BF phone daily support 4 wks p.p., then biweekly until 12 wks p.p.

Increased EBF at 12 wks p.p.; longer BF duration

Very Low

Howell et al. [76]

Tertiary hospital

Design: RCT

Data: Baseline, 3 wks, 3, 6 mo p.p.

n = 270 intervention

64% H; 36% AA

n = 270 Control

61% H; 39% AA; NY

p.p. behavioral education; BF tips, social support/self-management skills.

Longer BF duration; less likely to stop BF during first 6 mo p.p.

Moderate

Bream et al. [77]

Pediatric clinic

Design: Retrospective

Data: chart review first 14 d p.p., 2 mo p.p. survey

N = 355; 96% AA; Cleveland OH

BF mothers requesting

a breast pump or using one at 14 days p.p.

Breast-pumps did not increase EBF at 2 mo; less BF at 2 mo p.p.

Very Low

Mercier et al. [78]

University Hospital

Design: Observational Retrospective study

Data: chart review; hospital & 6–8 wks p.p.

N = 405; 54% AA; 11% As; 11% H;

Philadelphia

Exposure: Insurance status; Medicaid or commercial insurance

Among AA, no significant differences in BF rates AA with or without commercial insurance.

Low

  1. Abbreviations: A Asian; AA African American; AI American Indian; H Hispanic; W White; p.p. postpartum; PC peer counselor; RCT Randomized Controlled Trial. IBCL International Board Certified Lactation Consultant; PC peer counselor; EBF exclusive breastfeeding; BF breastfeeding; SIDS Sudden Infant Death Syndrome