Impact of Peer Counselors on Breastfeeding Outcomes in a Nondelivery NICU Setting

PURPOSE: Although the independent effects of lactation consultants and peer counselors have been shown to improve breastfeeding outcomes, the joint effects have yet to be considered, particularly in the neonatal intensive care unit (NICU) in nondelivery hospitals. Therefore, the objective of this study was to assess the effect of lactation staff type on breastfeeding outcomes during hospital stay after the addition of peer counselors to a NICU lactation program. SUBJECTS: A total of 596 mother-infant pairs admitted to Nationwide Children's Hospital, Columbus, Ohio, pre- and postlactation program expansion. DESIGN: A descriptive pre-/posttest study as conducted. MAIN OUTCOME MEASURES: Differences in provision of any maternal breast milk, exclusive breast milk, or direct breastfeeding during NICU stay and at discharge were evaluated pre and postprogram implementation. Logistic regression was used to determine associations between lactation staff type and each outcome during hospital stay. RESULTS: Infants receiving any breast milk during NICU stay increased from baseline to postprogram year 1 (63% vs 73%; P = 0.03). Direct breastfeeding increased from baseline to postprogram year 4 (42% vs 53%; P = 0.03). Mothers seen by only peer counselors were less likely to provide any breast milk at discharge, provide exclusive breast milk during stay or discharge, to be direct breastfeeding during stay or at discharge compared with mothers seen by both peer counselors and lactation consultants. CONCLUSIONS: NICU lactation programs should consider including both peer counselors and lactation consultants to improve breastfeeding outcomes during hospital stay.