From Bioactive Substances to Research on Breast-Feeding Promotion
Despite known health benefits, exclusive breast-feeding for at least 4 months is uncommon in many countries. In Mexico, most mothers initiate breast-feeding but few breast-feed exclusively. Objective: The objective was to examine the effectiveness of home visits by lay peer counselors to increase exclusive breast-feeding among mothers in a periurban area of Mexico. Methods: An ethnographic assessment conducted in 1994 that identified key maternal beliefs, practices, and needs was used to guide educational strategies. Lay counselors were recruited from the same community and trained by La Leche League. From March 1995 through September 1996, pregnant women were identified by community census and invited to participate. Women were enrolled into a randomized, controlled study of 3 groups: no intervention (control), 3 visits, and 6 visits during pregnancy and early postpartum. Data collection was performed by a social worker apart from the counselors. Exclusive breast-feeding was defined by WHO criteria. Results: The study enrolled 130 women; 52 were in the 3-visit group, 44 in the 6-visit group, and 34 in the control group. Study groups did not differ in the maternal characteristics or initiation of breast-feeding (96%). At 3 months postpartum, exclusive breast-feeding was practiced by only 12% of controls vs. 52% in the 3-visit group and 67% in the 6-visit group (P < 0.001, log rank test). In the first 3 months, significantly (P = 0.037) fewer intervention than control infants had an episode of diarrhea (11% vs. 26%, respectively). Intervention effectiveness was independent of maternal factors or birth hospital. Conclusions: This unique experimental study demonstrated a dramatic increase in exclusive breast-feeding and a significant reduction in infant illness in an urban community through well-designed maternal support including early intervention and repeated contact.
KeywordsPneumonia Marketing Diarrhea Malaysia Toll
Unable to display preview. Download preview PDF.
- Cervantes LE, Soto LE, Newburg DS, Ruiz-Palacios GM. Campylobacter jejuni receptor analogs present in human milk. Microbiol Ecol Health Dis 1991;45:527.Google Scholar
- Dimond HJ, Ashworth A. Infant feeding practices in Kenya, Mexico and Malaysia: the rarity of the exclusively breastfed infant. Hum Nutr Appl Nutr 1987;41A:51–64.Google Scholar
- Editorial. Lancet 1994;344:1237–1241Google Scholar
- Freed GL, Clark SJ, Lohr JA, Sorenson JR. Pediatrician involvement in breast-feeding promotion: A national study of residents and practitioners. Pediatrics 1995a;96:490–494.Google Scholar
- Hayani K, Guerrero ML, Morrow AL, Gomez HF, Winsor DK, Ruiz-Palacios GM, Cleary TG. Concentration of milk secretory immunoglobulin A against Shigella virulence plasmid-associated antigens as a predictor of symptom status in Shigella infected breast-fed infants. J Pediatr 1992;121:852–8.PubMedCrossRefGoogle Scholar
- Ryan AS. The resurgence of breastfeeding in the United States. Pediatrics 1997;99:E12 (http://www.Pediatrics.org/cgi/content/full/99/4/e12). Google Scholar
- [USDHHS] US Department of Health and Human Services. Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington DC: Office of Disease Prevention and Health Promotion; 1990. Objective 14.9. pp 379–380.Google Scholar
- [WHO] World Health Organization. Protecting, Promoting, and Supporting Breast-Feeding: The Special Role of Maternity Services. Geneva, Switzerland: WHO; 1989.Google Scholar
- [WHO] World Health Organization. The Innocenti Declaration: Progress and Achievements. Weekly Epidemiological Record 1998;73:25–30.Google Scholar