Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial

BJOG. 2014 Dec;121(13):1673-83. doi: 10.1111/1471-0528.12884. Epub 2014 May 26.

Abstract

Objective: To evaluate the effect of two postnatal professional support interventions on the duration of any and exclusive breastfeeding.

Design: Multicentre, three-arm, cluster randomised controlled trial.

Population: A cohort of 722 primiparous breastfeeding mothers with uncomplicated, full-term pregnancies.

Methods: The three study interventions were: (1) standard postnatal maternity care; (2) standard care plus three in-hospital professional breastfeeding support sessions, of 30-45 minutes in duration; or (2) standard care plus weekly post-discharge breastfeeding telephone support, of 20-30 minutes in duration, for 4 weeks. The interventions were delivered by four trained research nurses, who were either highly experienced registered midwives or certified lactation consultants.

Main outcome measures: Prevalence of any and exclusive breastfeeding at 1, 2, and 3 months postpartum.

Results: Rates of any and exclusive breastfeeding were higher among participants in the two intervention groups at all follow-up points, when compared with those who received standard care. Participants receiving telephone support were significantly more likely to continue any breastfeeding at 1 month (76.2 versus 67.3%; odds ratio, OR 1.63, 95% confidence interval, 95% CI 1.10-2.41) and at 2 months (58.6 versus 48.9%; OR 1.48, 95% CI 1.04-2.10), and to be exclusively breastfeeding at 1 month (28.4 versus 16.9%; OR 1.89, 95% CI 1.24-2.90). Participants in the in-hospital support group were also more likely to be breastfeeding at all time points, but the effect was not statistically significant.

Conclusions: Professional breastfeeding telephone support provided early in the postnatal period, and continued for the first month postpartum, improves breastfeeding duration among first-time mothers. It is also possible that it was the continuing nature of the support that increased the effectiveness of the intervention, rather than the delivery of the support by telephone specifically.

Keywords: Breastfeeding; intervention; professional support; randomised controlled trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breast Feeding*
  • Female
  • Humans
  • Parity*
  • Patient Education as Topic / methods
  • Postnatal Care / methods*
  • Pregnancy
  • Prenatal Care
  • Self-Help Groups
  • Telephone*