Table 3.
Summary of Randomized Controlled Trials Evaluating Breastfeeding Interventions Targeting Racial and Ethnic Minority Women
| Study | Quality rating | Study population | Intervention | Outcomes (intervention versus control) |
|---|---|---|---|---|
| Peer counseling | ||||
| Howell et al.52 (2014) | 1b | n=540; 64% Hispanic, 38% black | Educational session: 1 Hospital session: 1 Telephone session: 1 2-week telephone needs assessment: 1 |
Median breastfeeding duration: 12 versus 6.5 weeks |
| Anderson et al.53 (2007) | 1b | n=162; 81.9% Hispanic, 18.1% black | Home visits: 3 prenatal, 9 PP Hospital visits: daily perinatal |
Initiation: 90% versus 79% Exclusive breastfeeding: at 1 month, 33.8% versus 6.5%; at 2 months, 28.2% versus 1.6% |
| Sandy et al.54 (2009) | 1b | n=238; almost 100% Hispanic, less than 0.5% black | Home visits: weekly prenatal and PP Hospital visit: 1 PP |
Exclusive breastfeeding first week postpartum: 32% versus 20% |
| Edwards et al.55 (2013) | 1b | n=248; 100% black | Home visits: prenatal average=10, PP average=12 Telephone support: daily Breast pumps provided as needed |
Breastfeeding at >6 weeks: 29% versus 17% Wait ≥4 months to introduce complementary food: 21.3% versus 12.5% |
| Professional support | ||||
| Ryser50 (2004) | 1b | n=54; race/ethnicity not specified | Office visits: 4 (Best Start educational program) | Initiation: 61% versus 15% |
| Enhanced breastfeeding programs | ||||
| Ahluwalia et al.56 (2000) | 2c | PRAMS data n=3,724 PNSS data n=158,495 |
Enhanced breastfeeding education Breast pump loans Hospital-based programs Peer counseling Community coalitions |
Initiation increase from 1992 to 1996: PNSS, 31.6% to 39.5%; PRAMS, 33.6% to 42.1% Program with highest initiation rate in 1992: breast pump loans (55.6%) Program with highest initiation rate in 1996: hospital-based programs (52.2%) Program with largest change in initiation: hospital-based program (75%) |
| Karanja et al.57 (2010) | 2b | n=205; 100% AI/AN | Community-wide intervention Community-wide intervention+family component |
Initiation: 74% Breastfeeding: at 6 months, 38%; at 12 months, 17% |
Quality Rating Scale51: 1b=individual randomized controlled trials, 2b=individual cohort study or low-quality randomized controlled trials, and 2c=outcomes research; ecological studies.
AI/AN, American Indian/Alaska Native; PNSS, Pregnancy Nutrition Surveillance System; PP, postpartum; PRAMS, Pregnancy Risk Assessment Monitoring System.