Assessing Breastfeeding Duration: A Hands-On Guide to Program Evaluation
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Assessing Breastfeeding Duration: A Hands-On Guide to Program Evaluation Jessica Abrams, BS*, Kim Newton, BS*, Sonali Lappin*, Anne Merewood, MA*, IBCLC *Division of General Pediatrics, Boston University School of Medicine, The Breastfeeding Center, Boston Medical Center, Boston, MA BACKGROUND

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Assessing Breastfeeding Duration: A Hands-On Guide to Program EvaluationJessica Abrams, BS*, Kim Newton, BS*, Sonali Lappin*, Anne Merewood, MA*, IBCLC

*Division of General Pediatrics, Boston University School of Medicine, The Breastfeeding Center, Boston Medical Center, Boston, MA

BACKGROUND

STUDY METHODOLOGY: THE BMC EXAMPLE

SAMPLE RESEARCH QUESTIONS

  • 350 infants born at BMC were followed for primary care at BMC or 1 of 3 neighborhood health centers using the same electronic

  • medical record system

  • Breastfeeding defined as any amount of breast milk

  • Exclusion criteria: NICU admission, feeding status unknown,

  • infant death

  • We analyzed:

    • 1) Proportion of women breastfeeding over time, and 2) Factors associated with cessation at 6 months among women who initiated breastfeeding in the hospital (assessed by chi-square test).

  • What is the exclusive breastfeeding rate

  • among African-American mothers ages

  • 15-24?

  • Do foreign-born mothers begin

  • supplementation earlier than US-born

  • mothers?

  • Are women with access to lactation

  • consultants more likely to breastfeed

  • longer?

  • Is breastfeeding duration affected by

  • mothers who return to work?

  • Breastfeeding duration is assessed nationally

  • Breastfeeding duration is an important measure of breastfeeding

  • success

  • Many factors influence breastfeeding duration

OBJECTIVE

  • To provide practical pointers for lactation professionals wishing to

  • measure breastfeeding duration of their clients, programs, and

  • clinical settings

METHODS: CONSIDERATIONS

HOW DO OTHERS DO IT?

CONCLUSION

  • How many infants will you follow?

  • How will you choose a sample that represents your population

  • and offers meaningful results?

  • What variables will you look at?

  • How will you define breastfeeding duration?

  • Which point in time will you choose as an adequate measure?

  • Do the data already exist?

  • Should you collect it prospectively, or retrospectively from

  • another source?

  • Are you going to get a cross-section (“snapshot”) or follow the

  • same women over time?

  • Take into consideration: Mother’s race/ethnicity, birth place, SES,

  • education level, hospital of birth, WIC status, age, employment

  • status, health of mother, health and gestational age of baby

  • National data available can act as data sources, models, or

  • comparisons

  • Many factors need to be considered beyond simple duration of

  • breastfeeding

  • A comprehensive study design is essential in order to gather

  • meaningful data


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