Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women's Prenatal Breastfeeding Support, Intentions, and Outcomes.

This was a small pilot, so it could miss smaller differences in breastfeeding outcomes. Women were not randomly assigned; the comparison was before versus after the toolkit was introduced. The intervention combined provider counseling materials and peer-counselor referral, so it cannot show which part mattered. Interviewers knew which prenatal practice women came from, and answers were collected face-to-face, which may have made women report what they thought was expected. Breastfeeding duration relied on self-report, and breastfeeding beyond the early postpartum follow-up was not measured. Actual toolkit use was hard to count because counseling was sometimes documented elsewhere and some referrals were not submitted. Non-English speakers were not included because translators could not be funded.

The toolkit was developed through an NIH-funded project. One author is on the medical board of May & Meadow, a biotech start-up; the other named authors declared no competing financial interests.

Do not read the higher intention and referral rates as proof that the toolkit changed breastfeeding outcomes. Initiation and duration did not differ, and this was a small pilot.