Prenatal Counseling for Postpartum Health--A Randomized Trial

We propose a randomized trial to evaluate a prenatal counseling intervention designed to improve rates of breastfeeding and postpartum health. By analyzing real-time infant feeding data collected from 300 primiparous mothers using an app medical records and surveys conducted on enrollment and at 3 and 6 months postpartum we will advance understanding of best practices in prenatal counseling to promote postpartum health for diverse US women. In preliminary work with low-income pregnant women who were predominantly African-American we found that brief structured counseling about the maternal benefits of lactation significantly increased the proportion of mothers who were likely to breastfeed. We now propose to address the following specific aims: Aim 1: To assess the impact of prenatal counseling about the maternal health benefits of lactation on infant feeding behaviors and maternal mental health we will follow pregnant women carrying a singleton pregnancy from 34 weeks gestation to 6 months postpartum. We will recruit a diverse population of study participants in Stockton and Sacramento California. We hypothesize that this novel approach to promoting breastfeeding will strengthen mothers' intentions to breastfeed increase initiation of breastfeeding increase help-seeking for early lactation challenges increase milk expression (or 'pumping') and delay infant feeding of alternatives to the mother's own milk. Aim 2: To examine the effects of this intervention on the subgroup of mothers who experience pregnancy complications (i.e. gestational diabetes gestational hypertension pre-eclampsia preterm birth and/or Cesarean delivery) recognizing that these pregnancy complications which interfere with initiation of breastfeeding more commonly affect Black mothers. Our accomplished multidisciplinary team offers expertise in women's health pediatrics obstetrics trial design and statistical analyses and will produce at least 4 peer-reviewed manuscripts in keeping with HRSA MCHB's Strategic Research Issue IV. This work also aligns with: MCH Performance Domain: #3 in Perinatal & Infant Health and HealthyPeople 2020

Objectives:

MICH-21&23 as well as Performance Domain #14 and MICH-11.3 MICH-18.