Increasing Breastfeeding Initiation and Duration at a Community Level: An Evaluation of Sagkeeng First Nation’s Community Health Nurse and Peer Counselor Programs

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Abstract
The effectiveness of two Sagkeeng First Nation breastfeeding initiatives—prenatal instruction by a community health nurse and a postpartum peer counselor (PC) program for breastfeeding women—was evaluated at a community level through chart audits (1992 to 1997, n = 283). Breastfeeding initiation rates increased from 38% in 1995 to 60% in 1997 (OR = 2.2, 95% CI 1.2-4.1, P= .01, adjusted for birth weight and parity). PC clients were half as likely to wean (RR = 0.5, 95% CI 0.25-0.98, P= .04, adjusted for birth weight and parity), with 61% still breastfeeding at 2 months (vs 48% nonclients) and 56% at 6 months (vs 19%). PC clients had fewer problems (median 1 vs 2, P= .044) and greater satisfaction with breastfeeding (median5vs 4, P= .07). Qualitative interviews (n = 22) confirmed PC clients as more satisfied and more confident about breastfeeding, with fewer problems and more information.