Relationship between perinatal counseling and incidence of breastfeeding in an inner-city population

OBJECTIVE: We hypothesized that the cost of a lactation program can be reduced without significantly affecting the incidence of breastfeeding. STUDY DESIGN: We conducted a retrospective analysis of breastfeeding among all 7942 mothers whose neonates were admitted to the well baby nursery at Jacobi Medical Center (JMC) over a 44-month period We used multiway frequency analysis to compare the incidence of breastfeeding in three successive models of counseling: (1) full-time lactation coordinator, (2) obstetric personnel trained in breastfeeding counseling and full-time lactation coordinator, and (3) obstetricpersonnel and half-time lactation coordinator. Mothers were further dassified into three groups according to location of prenatal care and attendance at breastfeeding education sessions. RESULTS: Breastfeeding increased with the initiation of education and the involvement of obstetric personnel and did not significantly decrease when the lactation coordinator became half-time. The transition to model 3 resulted in decreased costs without significantly affecting the incidence of breastfeeding. Breastfeeding was significantly associated with counseling by obstetric personnel, with prenatal care at JMC, and with breastfeeding education sessions. CONCLUSION: Involving obstetric personnel in breastfeeding counseling may enhance the effectiveness of a lactation program. In our population, the most cost-conscious model included counseling by trained obstetric personnel and a half-time lactation coordinator.