Evaluation of the 'Best Start' Breast-feeding Education Program

Abstract
Objective: To compare the frequency of breast-feeding before and after the "Best Start" breast-feeding educational program was implemented. Design: Preintervention-postintervention trial. Setting: A women's health center and children's hospital serving a low-income population. Patients: Ninety mother-infant pairs of whom the infants were born between January 2 and February 28, 1993, compared with 90 mother-infant pairs of whom the infants were born between January 2 and February 28, 1994. Intervention: Best Start, a breast-feeding education program, was presented to health professionals and clerical staff of the Women's Health Center. At the first prenatal visit, a woman is asked, "What do you know about breast-feeding?" instead of "Are you going to breast-feed or bottle-feed this baby?" The program elicits and acknowledges the mother's concerns and then educates her about the benefits of breast-feeding. This is repeated at each prenatal visit. Outcome Measures: Sociodemographic data and breast-feeding rates of preintervention groups were compared with those of postintervention groups. Both hospital and outpatient records were reviewed. Results: In 1993, 13 (15%) of 86 mothers breast-fed at hospital discharge compared with 25 (31%) of 81 in 1994 (P<.03). At the 2-week clinic visit, 11(13%) of 86 were still breast-feeding in 1993 compared with 17 (21%) of 81 in 1994 (P>.20). The impact on mothers aged 19 years or less was particularly marked, with a tripling of the breast-feeding rate at hospital discharge from 11% (2/18) in 1993 to 37% (10/27) in 1994. Conclusion: This simple, low-cost educational intervention with a change in the manner of presentation significantly improved the breast-feeding rates of this low-income population. Arch Pediatr Adolesc Med. 1996;150:868-871.