Assessing Breastfeeding Duration: A Hands-On Guide to Program Evaluation Jessica Abrams, BS*, Kim Newton, BS*, Sonali

1. Assessing Breastfeeding Duration: A Hands-On Guide to Program EvaluationJessica Abrams, BS*, Kim Newton, BS*, Sonali Lappin*, Anne Merewood, MA*, IBCLC *Division of General Pediatrics, Boston University School of Medicine, The Breastfeeding Center, Boston Medical Center, Boston, MA BACKGROUND STUDY METHODOLOGY: THE BMC EXAMPLE SAMPLE RESEARCH QUESTIONS • 350 infants born at BMC were followed for primary care at BMC or 1 of 3 neighborhood health centers using the same electronic • medical record system • Breastfeeding defined as any amount of breast milk • Exclusion criteria: NICU admission, feeding status unknown, • infant death • We analyzed: • 1) Proportion of women breastfeeding over time, and 2) Factors associated with cessation at 6 months among women who initiated breastfeeding in the hospital (assessed by chi-square test). • What is the exclusive breastfeeding rate • among African-American mothers ages • 15-24? • Do foreign-born mothers begin • supplementation earlier than US-born • mothers? • Are women with access to lactation • consultants more likely to breastfeed • longer? • Is breastfeeding duration affected by • mothers who return to work? • Breastfeeding duration is assessed nationally • Breastfeeding duration is an important measure of breastfeeding • success • Many factors influence breastfeeding duration OBJECTIVE • To provide practical pointers for lactation professionals wishing to • measure breastfeeding duration of their clients, programs, and • clinical settings METHODS: CONSIDERATIONS HOW DO OTHERS DO IT? CONCLUSION • How many infants will you follow? • How will you choose a sample that represents your population • and offers meaningful results? • What variables will you look at? • How will you define breastfeeding duration? • Which point in time will you choose as an adequate measure? • Do the data already exist? • Should you collect it prospectively, or retrospectively from • another source? • Are you going to get a cross-section (“snapshot”) or follow the • same women over time? • Take into consideration: Mother’s race/ethnicity, birth place, SES, • education level, hospital of birth, WIC status, age, employment • status, health of mother, health and gestational age of baby • National data available can act as data sources, models, or • comparisons • Many factors need to be considered beyond simple duration of • breastfeeding • A comprehensive study design is essential in order to gather • meaningful data