***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Breastfeeding rates among low-income women in the east-south- central United States are among the lowest in the country . This study examined the effect of a peer counseling program on breastfeeding initiation and duration in a low-income rural population in West Tennessee . A postpartum survey and chart review were conducted with WIC clients at nine health departments . Response rate was 99 % ( 291/293 ) .  Breastfeeding initiation and duration at 6 weeks were increased in the peer counselor group ( n= 156 ) compared with women in the no-peer counselor group ( n= 135 ) ( 53 % vs. 33%,p<0.001 , and 26 % vs. 13%,p=0.006 , respectively ) . Multivariate analysis revealed that women in the peer counselor group were significantly more likely to initiate breastfeeding ( OR=2.43 , 95 % CI=1.23 - 4.67 ) and to be breastfeeding at 6 weeks ( OR=2.78 , 95 % CI=2.08 - 9.5 1 ) , than those in the no-peer counselor group One method used to determine utilization rates of cervical screening is  women 's self-report . Few studies have assessed the accuracy of this measure -- none has been conducted in Australia -- although there are a number of reasons for suspecting its validity . This study examined and quantified the accuracy of self-report of Pap smear use  among a r and omly selected sample of women from an Australian community .  Accuracy of Pap smear utilization self-report within a three-year period was assessed by comparison with pathology records . Results indicated that almost half of the women who have not had Pap smears within three years will be missed by a self-report measure of utilization . Some implication s for the measurement and use of self-report data are discussed BACKGROUND The purpose of this demonstration project was to test the effectiveness of a volunteer peer counseling program for promoting breastfeeding in a community . METHODS The two-year project was conducted in Iowa from September 1994 to September 1996 . Both intervention and control groups were rural low-income pregnant and postpartum women who qualified for the Women , Infants and Children 's ( WIC ) nutritional program . The intervention was initiated in two counties with 143 clients , of whom 72 completed the project . The control group was drawn from six counties that had received no significant breastfeeding promotion programs during the previous three years . The intervention was the assignment of trained volunteers with previous successful personal experience with breastfeeding as peer counselors  to low-income pregnant women . Both before and after the baby was born , the volunteers taught a series of in-home , one-to-one lessons about healthy diet and breastfeeding , and maintained informal contact to answer questions or help with concerns . RESULTS Women in the intervention group improved dietary intake when compared with the control group . Knowledge of breastfeeding and good nutrition improved slightly . Eighty-two percent of intervention compared with 31 percent of control group women initiated breastfeeding . Mean duration of breastfeeding for intervention and control group women was 5.7 and 2.5 weeks , respectively . At 4 weeks , 56 percent of intervention and 10 percent of control group women were still breastfeeding . CONCLUSION A volunteer peer counseling program that provides low-income women with role models , accurate information , support , and encouragement can increase the duration of breastfeeding , and thus contribute to healthier infants STUDY OBJECTIVE --Retrospective infant feeding data are important to the study of child and adult health patterns . The accuracy of maternal recall of past infant feeding events was examined and specifically the infant 's age when breast feeding was stopped and formula feeding and solid foods were introduced . DESIGN AND SETTING --The sample consisted of Bedouin Arab women ( n = 318 ) living in the Negev in Israel who were a part of a larger cohort participating in a prospect i ve study of infant health and who were delivered of their infants between July 1 and December 15 , 1981 . Data from interviews conducted 12 and 18 months postpartum were compared to the st and ard data collected six months postpartum . MAIN RESULTS --As length of recall increased there was a small increase in the mean difference , and its st and ard deviation , between the st and ard and recalled age when breast feeding was stopped and formula feeding and solid foods were started . Recall on formula feeding was less accurate than recall on solid foods and breast feeding . In particular , among those 61 % reporting formula use at the six month interview , 51 % did not recall introducing formula when interviewed at 18 months . The odds ratio ( 95 % CI ) of stunting versus normal length for age for formula fed versus breast fed infants based on recall data ( OR = 2.07 ; 95 % CI 0.82 - 5.22 ) differed only slightly from those based on the st and ard data ( OR = 2.21 ; 95 % CI 0.77 - 6.37 ) . The accuracy of a mother 's recall varied with her child 's nutritional status at the time of the interview , but not with other sociodemographic , infant , or interviewer characteristics . CONCLUSIONS --Retrospective infant feeding data based on maternal recall of events up to 18 months in the past can be used with confidence in epidemiological studies . However , data on formula feeding may not be as accurate as data on breast feeding and solid food feeding , and accuracy may decrease as length of recall increases This research examined the effect of peer support on  breastfeeding duration and exclusivity ( breastfeeding without supplements )  in a population of low-income women during the first 3 months postpartum . Participants in the peer counselor group ( n = 18 ) exhibited higher rates of exclusive breastfeeding across time than those without a counselor ( n = 18 ) , and more exclusive breastfeeding was associated with long duration overall . Mother 's career plans had the greatest effect on duration of breastfeeding .  Women who intended to return to work , attend school , or both breastfed 6 to 9 weeks less than participants who intended to stay home . Attendance at a breastfeeding class and knowing someone who had breastfed was significantly correlated with a longer duration of breastfeeding . Nutritionists from the Women , Infants and Children ( WIC ) Program were the primary source of breastfeeding information . Two main factors discouraged women from breastfeeding : returning to work , school , or both and the perception of a diminished milk supply . Greater emphasis should be placed on prenatal breastfeeding education for low-income women , and their mothers and gr and mothers should be included . Peer support is one important component of social support in the area of breastfeeding that community health nurses ( CHNs ) can utilize . CHNs are in a unique position to assist working mothers , provide support , and develop educational programs to enhance breastfeeding success in this population This study examined the effect of support from trained peer counselors on breastfeeding initiation , duration , and exclusivity among low-income urban women .  Training of counselors , under the supervision of a registered nurse certified in lactation , adapted education techniques from Paulo Freire to provide information about lactation management and other health care issues . The study compared infant feeding practice s of women who planned to breastfeed and received support from counselors ( counselor group , N=59 ) to women who requested counselors but , owing to inadequate numbers of trained counselors , did not have a counselor ( No-counselor group , N=43 ) . Women in the counselor group had significantly greater ( p<.05 ) breastfeeding initiation ( 93 percent vs. 70 percent ) , exclusivity ( 77 percent vs. 40 percent ) , and duration ( mean of 15 weeks vs. mean of 8 weeks ) than women in the no-counselor group . The findings suggest that peer counselors , well-trained , and with on-going supervision , can have a positive effect on breastfeeding practice s among low-income urban women who intend to breastfeed BACKGROUND Exclusive breastfeeding is recommended worldwide but not commonly practised . We undertook a r and omised controlled study of the efficacy of home-based peer counselling to increase the proportion of exclusive breastfeeding among mothers and infants residing in periurban Mexico City . METHODS Two intervention groups with different counselling frequencies , six visits ( 44 ) and three visits ( 52 ) , were compared with a control group ( 34 ) that had no intervention .  From March , 1995 , to September , 1996 , 170 pregnant women were identified by census and invited to participate in the study . Home visits were made during pregnancy and early post partum by peer counsellors recruited from the same community and trained by La Leche League . Data were collected by independent interview . Exclusive breastfeeding was defined by WHO criteria . FINDINGS 130 women participated in the study . Only 12 women refused participation . Study groups did not differ in baseline factors . At 3 months post partum , exclusive breastfeeding was practised by 67 % of six-visit , 50 % of three-visit , and 12 % of control mothers ( intervention groups vs controls , p<0.001 ; six-visit vs three-visit , p=0.02 ) . Duration of breastfeeding was significantly ( p=0.02 ) longer in intervention groups than in controls , and fewer intervention than control infants had an episode of diarrhoea ( 12 % vs 26 % , p=0.03 ) . INTERPRETATION This is the first reported community-based r and omised trial of breastfeeding promotion . Early and repeated contact with peer counsellors was associated with a significant increase in breastfeeding exclusivity and duration . The two-fold decrease in diarrhoea demonstrates the importance of breastfeeding promotion to infant health CONTEXT Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies . Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries . OBJECTIVE To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants . DESIGN The Promotion of Breastfeeding Intervention Trial ( PROBIT ) , a cluster-r and omized trial conducted June 1996-December 1997 with a 1-year follow-up . SETTING Thirty-one maternity hospitals and polyclinics in the Republic of Belarus . PARTICIPANTS A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed , 16491 ( 96.7 % ) of which completed the entire 12 months of follow-up . INTERVENTIONS Sites were r and omly assigned to receive an experimental intervention ( n = 16 ) modeled on the Baby-Friendly Hospital Initiative of the World Health Organization and United Nations Children 's Fund , which emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support , or a control intervention ( n = 15 ) of continuing usual infant feeding practice s and policies . MAIN OUTCOME MEASURES Duration of any breastfeeding , prevalence of predominant and exclusive breastfeeding at 3 and 6 months of life and occurrence of 1 or more episodes of gastrointestinal tract infection , 2 or more episodes of respiratory tract infection , and atopic eczema during the first 12 months of life , compared between the intervention and control groups . RESULTS Infants from the intervention sites were significantly more likely than control infants to be breastfed to any degree at 12 months ( 19.7 % vs 11.4 % ; adjusted odds ratio [ OR ] , 0.47 ; 95 % confidence interval [ CI ] , 0.32 - 0.69 ) , were more likely to be exclusively breastfed at 3 months ( 43.3 % vs 6.4 % ; P<.001 ) and at 6 months ( 7.9 % vs 0.6 % ; P = .01 ) , and had a significant reduction in the risk of 1 or more gastrointestinal tract infections ( 9.1 % vs 13.2 % ; adjusted OR , 0.60 ; 95 % CI , 0.40 - 0.91 ) and of atopic eczema ( 3.3 % vs 6.3 % ; adjusted OR , 0.54 ; 95 % CI , 0.31 - 0.95 ) , but no significant reduction in respiratory tract infection ( intervention group , 39.2 % ; control group , 39.4 % ; adjusted OR , 0.87 ; 95 % CI , 0.59 - 1.28 ) . CONCLUSIONS Our experimental intervention increased the duration and degree ( exclusivity ) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life . These results provide a solid scientific underpinning for future interventions to promote breastfeeding Often , efforts to improve overall population health require identifying and targeting programs to specific high-risk population s. Breastfeeding is an example . In order to determine initiation and duration rates among various groups in the City of Toronto , a r and om sample of 434 mothers with infants at four months of age was surveyed to determine the prevalence of breastfeeding and major impacts on its duration . The study found that , overall , 83 % of mothers initiated breastfeeding at birth . The greatest rate of decline occurred during the first month . At four months postpartum , 57 % of mothers continued to breastfeed , including 35 % who were exclusively breastfeeding and 22 % who were supplementing breast milk with formula .  Breastfeeding duration was related to a number of factors , including information and support , parity , education , use of formula supplements and country of birth . Specific groups are identified for targeted programs , and a number of strategies are 
    Output:
    
INTERPRETATION The telephone-based peer support intervention was effective in maintaining breast-feeding to 3 months post partum and improving satisfaction with the infant feeding experience .
The high satisfaction with and acceptance of the intervention indicates that breast-feeding peer support programs , in conjunction with professional health services , are effective