P3.038: Empowering Mothers for Breastfeeding Retention And Counseling on Exclusivity: A Randomized Controlled Trial Exploring the Value of Educating and Utilizing Medical Student Lactation Counselors

Background: Breastfeeding provides numerous benefits for both mother and baby compared to formula, yet exclusively breastfeeding rates start at 62.6% at birth and drop to 24.9% by six months. Previous research recognizes the lack of societal, relational, and physician support as barriers to breastfeeding. This study’s primary objective is to evaluate the efficacy of weekly lactation counseling by trained medical students to primiparous mothers in increasing exclusive breastfeeding rates at 6 weeks. Secondly, this project aims to evaluate the training as a model for building medical student competence in breastfeeding support.

Methods: Medical students took a pre-test to determine baseline breastfeeding knowledge and then underwent 12 hours of online training. Students recruited postpartum primiparous mothers of healthy infants intending to exclusively breastfeed at Loma Linda University Medical Center who were subsequently randomized to the intervention group or control group. The intervention group received weekly informational pamphlets and calls providing breastfeeding support by the medical students for the first 6 weeks postpartum. The control group participants received one call and survey at 6 weeks postpartum to assess their breastfeeding status. After completing the protocol with 6-10 patients, medical students took a post-test to reassess their breastfeeding medicine knowledge.

Results: We enrolled a total of 85 patients into our study; 47 in the intervention group and 38 in the control group. Using the chi-squared test, we found a significant difference in the exclusive breastfeeding and formula rates at six weeks postpartum between the control and intervention group (relative risk 2.83; p = 0.0016). 29.8% of the intervention group were exclusively breastfeeding compared to 10.5% of the control group. 10.6% of the intervention group were supplementing breastfeeding with formula compared to 26.3% of the control group. No mothers in the intervention group were only formula feeding compared to 13.2% of the control group. Finally, the lost to follow up rates were higher for the intervention group (59.6%) compared to the control group (50.0%), but this difference was not statistically significant according to the chi-squared test of independence (p = 0.189).

Conclusion: Our training and utilization of medical students as lactation counselors increased exclusive breastfeeding rates at 6 weeks. Our project serves as a model for medical students as lactation counselors to provide new mothers with breastfeeding support helping address known barriers to breastfeeding. We will continue to recruit to increase our sample size, and we will analyze pre- and post-tests taken by medical students to assess for increased breastfeeding knowledge. Future work requires minimizing mothers who are lost to follow up, determining how this can be incorporated into medical school curriculum, and sharing our methodology with other medical centers to assess reproducibility.