An Evaluation of a Perinatal Education and Support Program to Increase Breastfeeding in a Chinese American Community

Introduction In 2015, a community health center implemented a multipronged, Chinese language, health education initiative to increase breastfeeding. Perinatal education, hospital visits after delivery, and postpartum support were implemented to provide informational and emotional support. This study evaluates the impact of the breastfeeding program for Chinese American women. Methods This is a quasi-experimental study to assess the change in any and exclusive breastfeeding at 4-6 weeks postpartum. A difference-in-differences regression analysis was used to determine change in breastfeeding attributable to the program at an intervention site after adjusting for change in a control site during the same period. Change in breastfeeding was also examined by sociodemographic characteristics. Results A total of 1475 women who received perinatal care at two community center sites in 2014 and 2016 were included in the study. Within the women who received the intervention, any breastfeeding increased by 24 percentage points to 71% and exclusive breastfeeding increased by 13 percentage points to 27%. After adjusting for the change in the control group during the same period, the increases in any and exclusive breastfeeding attributable to the program were 17 (p < 0.01) and 9 percentage points (p < 0.05), respectively. Primiparous women and those who have been in the US longer than 5 years experienced the highest increase in any breastfeeding from the program. Exclusive breastfeeding was most improved in those with non-Medicaid insurance. Conclusions A bilingual and bicultural breastfeeding program incorporated into routine pregnancy care at an intervention site experienced increases in both any and exclusive breastfeeding, even after adjusting for changes in breastfeeding in a control group. Significance Statement What is known on this subject? Chinese Americans are the least likely to breastfeed among all ethnicities in New York City. Cultural and language barriers plus the lack of Chinese language resources contribute to low breastfeeding rates. What this study adds? A bilingual and bicultural breastfeeding program of perinatal education and postpartum support incorporated into routine pregnancy care increased both any and exclusive breastfeeding in a Chinese American population. Increase in any breastfeeding was the greatest in primiparous women and those who had been in the US for a longer time and increase in exclusive breastfeeding was greatest in women not using Medicaid insurance.