MCHbest. NPM 4: Breastfeeding
Strategy. Home Visits (Professionals Other than Lactation Consultants or Peer Counselors)
Approach. Provide training and coaching to MIECHV home visiting staff to promote breastfeeding best practices.
Overview. Home visits in the first several weeks following birth may prolong the duration of exclusive breastfeeding. Postnatal support should focus on both psychosocial and practical aspects of breastfeeding. Mothers with no or little previous breastfeeding experience require special attention.1,2
Evidence. Moderate. Home visits provided by professionals (other than lactation consultants or peer counselors) appear to be effective for increasing both breastfeeding initiation and 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. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. Mother/family (through home visitors, community health workers, and health care providers).
Outcome. Duration and Exclusivity. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. There are currently 14 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Provide training and coaching to MIECHV home visiting staff to promote breastfeeding best practices,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).
1 McGinnis, S., Lee, E., Kirkland, K., Miranda-Julian, C., & Greene, R. (2018). Let’s talk about breastfeeding: The importance of delivering a message in a home visiting program. American Journal of Health Promotion, 32(4), 989-996.
2 Kronborg, H., Væth, M., Olsen, J., Iversen, L., & Harder, I. (2007). Effect of early postnatal breastfeeding support: a cluster‐randomized community based trial. Acta Paediatrica, 96(7), 1064-1070.