Project Summary/Abstract A goal of Breastfeeding Education Support Tool for Baby (BEST4Baby) is to conduct exploratory research, primarily through the use of focus groups, to accomplish the following:  Understand the status of exclusive breastfeeding and other infant feeding practices from the perspective of mothers in a 6-cluster area of Belagavi District, Karnataka, India,  Assess the acceptability of the use of peer counselors and their effect on exclusive breastfeeding rates and other breastfeeding practices,  Assess institutional needs for creating a successful peer counseling model to optimize breastfeeding practices,  Understand the barriers as well as facilitating factors associated with recruiting and retaining community-based peer counselors,  Facilitate the design of an effective and culturally-appropriate training curriculum for mothers with breastfeeding experience to prepare them to counsel and support pregnant women and breastfeeding mothers during the BEST4Baby pilot-testing phase,  Generate information to determine how a mobile technology (mHealth) platform can support peer counselors and promote their effectiveness and retention over an extended period of time. Based upon the exploratory research, technological expertise will be applied to the design and implementation of a breastfeeding training program for peer counselors, which will include multimedia content to aid counselors in educating and supporting mothers to increase their commitment to exclusively breastfeed their infants to six months and adopt other recommended breastfeeding practices. Orientation to the use of mobile health (mHealth) technology will be integrated into peer counseling training of 24 mothers with breastfeeding experience—or 4 from each of the 6 clusters participating in BEST4Baby. The mothers recruited for training must consent to training, serving as counselors, and assessing usability and acceptability of the BEST4Baby mHealth platform. After completing training, each counselor will be assigned to 5 pregnant women who consent to receiving breastfeeding counseling. Two counseling sessions will be scheduled prior to delivery, and then peer counselors will visit mothers post-delivery in their homes. Research staff will also visit mothers to collect data on breastfeeding practices and to obtain feedback on the benefit of BEST4Baby and mHealth tools used during the course of the project. A comparison group of mothers will be utilized to evaluate the influence of peer counseling on breastfeeding practices.

Project Narrative Breastfeeding is good for mothers, good for babies and an especially cost-effective means for promoting infant survival, healthy growth and development. Yet a very large portion of the world’s infants, including those in India, lack the benefit of optimal breastfeeding practices. Breastfeeding Support Tool for Baby (BEST4Baby) will utilize exploratory research and community involvement to design and integrate mobile technology, culturally-appropriate breastfeeding education, and a community-based approach to increase breastfeeding support to mothers; and the initiative will provide evidence that the BEST4Baby approach can achieve the public health objective of improving rates of exclusive breastfeeding for 6 months and continued breastfeeding for an appropriate time thereafter.