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Effectiveness of peer counselors: what we know

Effectiveness of peer counselors: what we know. Ann Dozier, RN, PhD Community and Preventive Medicine University of Rochester. Mother to Mother Support. Historically support, information, guidance perinatal period mothering the mother. Mother to Mother Support.

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Effectiveness of peer counselors: what we know

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  1. Effectiveness of peer counselors: what we know Ann Dozier, RN, PhD Community and Preventive Medicine University of Rochester

  2. Mother to Mother Support • Historically • support, information, guidance • perinatal period • mothering the mother

  3. Mother to Mother Support • Declined in US in starting in 1930s • commercialization of infant formula • medicalization of maternal child health care • increasing trust/confidence in medical profession • science = progress • social influences • changes in mobility – break up of family networks

  4. Perinatal Support • La Leche League • established 1956 • “when breastfeeding was a lost art, and bottle feeding was in its heyday” • Midwifery • Doula role

  5. Perinatal Support • BF peer counseling • formalized role • recent phenomenon • direct outgrowth of 1984 Surgeon General’s workshop • broaden base of support for BF

  6. BF Peer Counseling • Goal • Facilitating the development of an environment that is conductive to initiating and sustaining lactation • Provide informational, instrumental and emotional support • Effectiveness based on shared experience • One-to-one peer support

  7. BF Peer Counseling • Training • standardized • WHO/UNICEF program – increased exclusivity • Peer counselors • mothers with BF experience • Commitment to BF • desire to connect with mothers from similar backgrounds • can be paid or volunteer

  8. BF Peer Counseling – Factors for success • leadership and management support • program supervision • standardized and timely initial and ongoing training • support for peer counselors • access to IBCLCs • community partnerships for making and receiving referrals. Integrating peer support within the overall health system seems to contribute to the ongoing maintenance of a program.

  9. BF Peer Counseling • Effectiveness • Initiation – increased (esp. low income/lacking support) • If provided at or shortly after childbirth • Exclusivity - increased • Women with PC 1.5 more likely to exclusively BF at 3 mo • PC increases exclusive BF by 2.6 to 4 weeks • Duration – no effect Other benefits

  10. BF Peer Counseling • Issues • type of peer counseling • phone, in person, home visiting • Frequency; consistency • practice vs. program based • targeted group • type of training for counselor • impact when combined with professional support

  11. References • Rossman, B. 2007. Breastfeeding Peer Counselors in the US: Helping to Build a Culture and Tradition of Breastfeeding. Journal of Midwifery Women’s Health, 52, 631 – 637. • Dyson, Mccormick & Renfew. 2009. Interventions for promoting the initiation of breastfeeding. Cochrase Database of Systematic Reviews. • Shealy KR, Li R, Benton-Davis S, Grummer-Strawn LM. The CDC Guide to Breastfeeding Interventions. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2005. • Britton C, McCormick FM, Renfrew MJ, Wade A, King SE. Support for breastfeeding mothers. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD001141. • Guise, JM. Et al, 2003. The Effectiveness of Primary Care- Based Interventions to Promote Breastfeeding: Systematic Evidence. Review and Meta-Analysis for the US Preventive Services Task Force. Ann Fam Med 2003;1:70-80.

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