Breastfeeding Conversations with a Home Visitor and Breastfeeding Continuation in Postnatal Enrollees.

Introduction: Breastfeeding is associated with many health benefits for both mothers and children, yet U.S. breastfeeding rates are far below the Healthy People 2030 goals. Furthermore, disparities in breastfeeding rates exist, whereby some demographic groups have even lower rates. This study examines the association between dosage of breastfeeding conversations with a home visitor on breastfeeding continuation in participants who enrolled postnatally.

Methods: This cohort study examines the impact of breastfeeding conversations with a home visitor on breastfeeding continuation on 1,422 mother-child pairs enrolled postnatally in Healthy Families New York (HFNY), a family support home visiting program. Multivariable logistic regression models analyzed longitudinal data, adjusting for several known predictors of breastfeeding that could confound the association between breastfeeding conversations and breastfeeding continuation.

Results: The analyses reveal a significant association between the rate of breastfeeding conversations during home visits in the preceding period and increased odds of breastfeeding continuation for 1-2 months (p = 0.013), 2-3 months (p < 0.001), 3-6 months (p < 0.001), and six months or greater (p = 0.001). The dose-response relationship and longitudinal nature of the data could suggest causality. Importantly, the impact of breastfeeding conversations is more pronounced among mothers born in the U.S., a group with known disparate breastfeeding outcomes. Further, this study finds that the number of home visits predicts breastfeeding continuation past six months (p < 0.001).

Discussion: This study offers important insights into the role of a home visiting intervention to promote breastfeeding and reduce breastfeeding disparities without the excessive costs of an intervention designed solely for breastfeeding.