Find State ESMs

Evidence Level: Moderate. Aligns with MCHbest strategy "Peer Counselors" (https://www.mchevidence.org/tools/strategies/4-2.php). Find other NPM 4 mother/family-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Emerging. Aligns with Community-based breastfeeding support designation model as documented by the Communities Supporting Breastfeeding (KS) program in AMCHP's Innovation Hub.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percent of WIC participants who breastfeed exclusively through six months

Numerator: Number of WIC participants receiving breastfeeding peer counselor services who were exclusively breastfeeding at 3 months

Denominator: Number of WIC participants who receive breastfeeding peer counselor services

Significance: According to the Surgeon General’s Call to Action to Support Breastfeeding “one of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed. However, in the U.S., while 75% of mothers start out breastfeeding, only 13 percent of babies are exclusively breastfed at the end of six months…A mother’s ability to begin and to continue breastfeeding can be influenced by a host of community factors… programs such as the U.S. Department of Agriculture’s WIC program can expand the support that women ideally have received in the hospital and help extend the duration of breastfeeding.” It focuses on increasing exclusive breastfeeding at 3 months, which is a milestone towards reaching exclusive breastfeeding at 6 months and one that is more within the control of the WIC peer counselor program.

Data Sources and Data Issues: Massachusetts WIC data system

Year: 2023

Unit Type: Percentage, Unit Number: 100

Evidence Level: Moderate. Aligns with MCHbest strategy "Peer Counselors". Find other NPM 4 mother/family-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Emerging. Aligns with Nutrition educational materials based on "emotional pulse points" as documented by the Touching Hearts and Minds (MA) program in AMCHP's Innovation Hub.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: To improve breastfeeding initiation rates and have an impact on breastfeeding rates at 1 and 3 months post-partum.

Numerator: Number of pregnant and postpartum WIC clients served by breastfeeding peer counselors

Denominator:

Significance: Peer counselor interventions appear to be effective and are more likely to influence initiation than exclusivity at 6 months. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall.

Data Sources and Data Issues: Beauregard JL, Hamner HC, Chen J, Avila-Rodriguez W, Elam-Evans LD, Perrine CG. Racial Disparities in Breastfeeding Initiation and Duration Among U.S. Infants Born in 2015. MMWR Morb Mortal Wkly Rep 2019;68:745–748. DOI: http://dx.doi.org/10.15585/mmwr.mm6834a3 McCoy, M. B., Geppert, J., Dech, L., & Richardson, M. (2018). Associations between peer counseling and breastfeeding initiation and duration: an analysis of Minnesota participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Maternal and child health journal, 22(1), 71-81.

Year: 2023

Unit Type: Count, Unit Number: 100,000

Evidence Level: Moderate. Aligns with MCHbest strategy "Peer Counselors". Find other NPM 4 patient-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: No similar strategies found in Innovation Hub.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Direct services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: By 2025, the number of eligible WIC participants who receive breastfeeding peer counselor services will be 31,425 (15% increase from FY19 baseline of 27, 587).

Numerator: Number of eligible WIC participants who receive breastfeeding peer counselor services (determined by having a signed Breastfeeding Peer Counselor Program Letter of Agreement in the Crossroads WIC System)

Denominator:

Significance: Systematic literature reviews have returned similar findings: “Dedicated lactation specialists may play a role in providing education and support to pregnant women and new mothers wishing to breastfeed and to continue breastfeeding (duration) to improve breastfeeding outcomes.”1 1 Patel, S., & Patel, S. (2016). The Effectiveness of Lactation Consultants and Lactation Counselors on Breastfeeding Outcomes. Journal of Human Lactation, 32(3), 530–541.

Data Sources and Data Issues: NC Crossroads WIC System

Year: 2023

Unit Type: Count, Unit Number: 100,000

Evidence Level: Moderate. Aligns with MCHbest strategy "Peer Counselors". https://www.mchevidence.org/tools/strategies/4-2.php Find other NPM 4 strategies in MCHbest. https://www.mchevidence.org/tools/strategies/search/refine.php?NPM=4

Alignment with field-based evidence through Innovation Hub: Aligns with Innovation Hub's Communities Supporting Breastfeeding Program. https://amchp.org/wp-content/uploads/2021/05/Communities-Supporting-Breastfeeding.pdf

Measurement Quadrant: Quadrant 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Enabling services level of pyramid

Essential Public Health Services: 7. Assure effective and equitable health systems

Service Recipient: Activities directed to families/children/youth

Goal: Increase the percentage of eligible pregnant and postpartum WIC participants who received at least three contacts from a WIC Breastfeeding Peer Counselor.

Numerator: This is a new ESM for FY23

Denominator: This is a new ESM for FY23

Significance: Breastfeeding is the normative standard for infant feeding and nutrition and can result in improved infant and maternal health outcomes. Mothers who receive help and support when they need it are more likely to reach their breastfeeding goals and meet their infant’s complete nutritional needs. . A mother’s ability to begin and continue breastfeeding can be influenced by a host of community factors, and programs like WICs breastfeeding peer counselors can provide important coaching to enable and sustain breastfeeding efforts in WIC clients. Peer counseling interventions greatly improve breastfeeding initiation, duration, and exclusivity.

Data Sources and Data Issues: WIC program data

Year: 2023

Unit Type: Percentage, Unit Number: 100