Prenatal Lactation-Focused Motivational Interviewing

1. Recruitment efforts will be made in the community via advertisements, online
advertisements (e.g., Craigslist, Facebook), and in-person at various clinics and
health fairs in the geographic area.

2. Prospective participants will contact the investigators via email or by calling the
study phone number listed on the advertisements or verbally expressing interest
in-person.

3. Once a participant indicates interest by contacting study personnel, a 5-minute
screening interview will be conducted with the prospective participant using the
screening questionnaire to ensure eligibility criteria are met. For those who do not
qualify or agree to participate, the age and reason for non-qualification or
declination to participate will be recorded; any other data will be destroyed by
shredding or electronic shredding. For those who do qualify, name and contact
information will be kept confidential and maintained in a locked room.

4. Participants will be asked to rate on a scale of -10 to +10 about their certainty that
they will provide exclusive breastmilk to their babies for first six months. Responses
from this item will be used as the covariate in the covariate adaptive randomization
technique.

5. Eligible subjects will be invited to participate in the study, either in an exam room
at West Virginia University's Family Medicine's clinic, participant's home, private
room in the Quin Curtis Center for Psychological Services, or in another agreed-upon
community location (e.g., church). The location of the study procedures is chosen by
the participant.

6. At the start of this session, participants will be given an overview of the study, and
the researcher will go over the consent form with them.

7. Following consent procedures, video-recording will begin, and all participants will
complete the prenatal interview. After this interview, participants will complete five
self-report measures, which include the Infant Feeding Knowledge Form, the Iowa Infant
Feeding Attitudes Scale, Brief Breastfeeding Attitudes Questions, Perinatal Anxiety
Screening Scale, and the Knowledge of Infant Development Inventory.

8. Intervention

1. Participants assigned to the MI condition will receive an approximately 45 minute
intervention provided a masters-level supervised psychologist with training in
Motivational Interviewing.

2. Participants who have been randomly assigned to participate in the
attention-control group session will receive approximately 45 minutes of
psychoeducation on typical developmental stages and infant feeding methods.

Inclusion Criteria:

1. Age 18 years or older

2. Female

3. Pregnant

4. At least 27 weeks pregnant

5. Able to read, write, speak, and understand English

6. Has access to a phone (either mobile or landline)

7. Lives within driving distance of Morgantown, WV, or is willing to travel to a
location that is within driving distance to Morgantown, WV

Exclusion Criteria:

1. Multiple pregnancy

2. Within one week of due date

3. Has any of the following conditions:

- Developmental or intellectual disability

- Schizophrenia

- Untreated, active tuberculosis

- Human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS)

- Human T-cell lymphotropic virus type I or type II

- History of lumpectomy or radiation to breast

4. Uses or is dependent upon any of the following substances (Moretti, Lee, & Ito,
2000):

- Heroin

- Cocaine

- Methamphetamines

- Marijuana

- Phencyclidine (PCP)

- Non-prescription opioids (e.g., morphine, oxycodone, hydrocodone)

5. Undergoing any of the following medications/treatments (American Academy of
Pediatrics, 2001):

- Antiretrovirals

- Cancer chemotherapy (e.g., antimetabolites)

- Radiation therapy

- Acebutolol

- Atenolol

- Bromocriptine

- Aspirin (salicylates)

- Ergotamine

- Lithium

- Phenobarbital

- Primidone

- Sulfasalazine (salicylazosulfapyridine)