Provision of support strategies and services: results from an internet-based survey of community-based breastfeeding counselors.

This study examined the determinants of support strategies and services provided by community-based breastfeeding counselors (CBBCs) and compared differences in extent of support provided by paid and volunteer counselors. Participants (N = 847) in this internet-based survey were mostly White/Caucasian (74.9%), college-educated (59.0%), and paid CBBCs (63.8%). The majority (75.9%) of volunteer CBBCs compared with their paid full-time (52.1%) and paid part-time (47.4%) counterparts had completed college. Being a full-time paid compared with volunteer/unpaid CBBC was associated with face-to-face counseling (OR = 3.69; 95% CI: 1.93, 7.06), use of client-centered counseling skills (OR = 6.23; 95% CI: 3.40, 11.45), making referrals to social service agencies (OR = 13.18; 95% CI: 6.86, 25.32), and helping position baby (OR = 3.77; 95% CI: 1.64, 8.69). Because of the disparities in CBBC usage of breastfeeding support strategies and continuing education between paid and volunteer CBBCs, there is a need to examine differences in training curricula and determine the facilitators and barriers of continuing education.